At the RMA Network we often get many questions surrounding the topic of egg donation and surrogacy for intended parents. In most cases, if a couple cannot be helped through the process of in vitro fertilization (IVF), they may want to consider using donor eggs and sometimes donor embryos to achieve parenthood. Surrogacy is also another option available, which is an arrangement where a woman carries and delivers a child for another couple or person. We had a chance to sit down with Dr. Daniel J. Kaser from our Marlton, New Jersey office for further clarity on these two very important options for achieving parenthood.
Medically speaking, how does gestational surrogacy through egg donor-ship work?
Dr. Kaser: The in vitro fertilization (IVF) – donor egg – gestational carrier process is a series of steps in which eggs are removed from one woman, put with sperm to create embryos which are then implanted back in another woman’s uterus. Patients may choose to use fresh or frozen eggs from a known or anonymous, screened donor. The resulting embryos can then undergo genetic testing and cryopreservation for subsequent transfer to the gestational carrier. It is possible to work with a known surrogate, or one you match with through an agency. The team at RMA works closely with both the matched egg donor and gestational carrier to coordinate all aspects of the IVF treatment cycle.
Is RMA’s protocol different from those of other agencies or fertility centers?
Dr. Kaser: One of the unique paradigms we offer at RMA involves comprehensive chromosomal screening (CCS), with embryo cryopreservation and subsequent single embryo transfer. This approach involves testing whether an embryo has the correct number of chromosomes and is capable of developing into a healthy pregnancy. CCS may decrease miscarriage rates and also improve the live birth rate per transfer. In addition to testing the health of the embryo by looking at the other chromosomes, CCS also tests the sex chromosomes, making it possible to determine whether a particular embryo is male or female. Some patients prefer to know this information when selecting an embryo to transfer.
It is possible to create embryos for transfer at any time, even before a patient matches with a gestational carrier. The embryos can then be frozen for subsequent transfer. This embryo cryopreservation step not only allows greater scheduling flexibility for these cycles, but permits genetic testing of the embryos, improves live birth rates and important obstetric and neonatal outcomes for the carrier and child.
What kind of screening is involved?
Dr. Kaser: Patients undergo routine medical screening, including history and physical exam. They also meet with a mental health counselor to discuss the unique challenges of parenting on your own, and also issues related to the intended parent-gestational surrogate relationship, and age-appropriate ways of disclosure to your children. We also do infectious disease screening blood work that is required by the U.S. Food and Drug Administration. Due to the need for this blood work to be current at the time of egg insemination, most men choose to freeze their sperm ahead of time for use when eggs are available for IVF.
How does the RMA Network assist with the egg donor / gestational surrogacy process? How does RMA facilitate the connection between all involved?
Dr. Kaser: Men wanting to become single fathers through egg donation and gestational surrogacy meet with our third-party, or collaborative, reproduction team. Consultation involves meeting with physicians, nurses, mental health and financial counseling. The initial visit can be done in-person in New Jersey, or remotely by phone or secure video connection. This team coordinates all aspects of your care: from doing the necessary medical screening, to helping select an egg donor, and providing you with experienced references for gestational surrogacy agencies and reproductive lawyers to help draw up the necessary legal contracts.
Are there any mandatory state or federal laws to adhere to in these cases?
Dr. Kaser: There are many important legal issues to consider when working with a gestational carrier. As intended parents’ rights and obligations can vary from state to state according to where the gestational carrier lives, we recommend working with an experienced attorney that specializes in third-party reproduction. At RMA we only work with carriers from surrogacy-friendly states to assure that legal parentage is established without question. Our staff can assist you in finding the legal professionals and resources necessary to make these important decisions.
How many of these particular procedures has RMA performed? How many do most doctors at RMA perform? How many single would-be fathers does RMA work with (if that’s disclosable)?
Dr. Kaser: Single parenting by choice is becoming an increasingly common path to parenthood. Since the RMA Network of fertility clinics opened in 1999, we have helped thousands of single men and women start their families. Fewer men have taken this path, but those who have already done so, have indeed established a clear way forward. Men interested in learning more about this option can take the first step by scheduling an in-person or online consultation with one of our experts in third-party reproduction.
What is the likelihood of success of these procedures?
Dr. Kaser: Live birth rates with egg donation and gestational surrogacy are well over 60% per single embryo transfer. Typically, additional embryos are available for later transfer, in case the first cycle is not successful or if a patient wants to return at a later date to have another child.
As a doctor, what advice do you have for other men pursuing this option? Are there special pitfalls they should be aware of, or certain credentials they should ensure a fertility center has before signing on with them? On average, how long does the entire process take?
Dr. Kaser: For single men interested in pursuing this option, we encourage them to plan ahead. Not only can this be an expensive process that is not covered by insurance, from the time of first consultation to taking home a baby, it can take 18 to 24 months. The end result could not be more rewarding, but it takes some time.
Three important points for men considering to start their family this way: 1) obtain expert legal counsel from a lawyer who specializes in third-party reproduction; 2) contract with a reputable gestational surrogacy agency that extensively screens potential candidates; and 3) only work with a carrier who is a good match for you.
What kind of financial investment does gestational surrogacy via an egg donor require, and does RMA offer any special financial help, or possibility of reimbursement?
Dr. Kaser: Becoming a father through egg donation and gestational surrogacy requires a considerable investment of time, energy and money, not only for the medical treatment, but also for the legal contracts, agency fees and other expenses for the involved parties.
We hope that you found these answers to to be helpful as you begin your journey to parenthood. Please remember that you can also contact us directly for more in-depth information at 407-804-9670.