The AFA Blog

A Night with Jodi Picoult

by Merry Armentrout

I think I've met my soul mate.  Before my husband goes on a jealous rampage, I should mention this soul mate is a happily married woman with three children- so no competition Brian, I promise.  This is important for him because I spent the night with Jodi Picoult last night. It's not quite as racy as it sounds, but that's what the event was called- "A Night with Jodi Picoult".  Jodi Picoult is a bestselling author of 17 books, and she has a new one coming out on March 1st which is very relevant to The AFA's mission.  That's one of the reasons I drove an hour away to spend almost 2 hours listening to Jodi Picoult talk about storytelling, her books and her life. 

I wasn't quite sure what to expect when meeting Jodi. Reading her books is similar to riding a roller coaster (of emotions)- the subjects aren't light hearted, and the story lines make you think, make you question.  Here's a little surprise...Jodi wants you to think, wants you to question your beliefs. When she picks up a pen she wants to put every reader on that emotional roller coaster and make it a ride you won't forget.  Jodi is down to earth, funny, engaging, brilliant, insightful and most of all, real. I warned you I have a bit of a obsession. 

She is known to write about controversial topics- such as high school shootings, molestation, religion, science, suicide, to name a few.  One of the audience members asked her why she chose to write about such hot button topics. She said she will get an idea about a subject for a book, and knows when it's the right one when she can't stop thinking about it. Jodi says her goal as a writer is to have the reader walk away from the book not knowing how Jodi feels about the issue.  She talked about the importance of giving each side of an issue a voice- she does this through her characters. Many of us are shaped by our parent's opinions, and haven't taken the time to look at an issue through our own eyes. She allows readers to see all sides to the argument, and then the reader can decide what they believe or don't believe, what they feel is right or wrong. 

Jodi's new book, Sing You Home, will be available on March 1st. Below is a synopsis of the book from her website. I read this synopsis, and then directly figured out her appearance schedule, bought a ticket- and thus the obsession begins...

"Zoe Baxter has spent ten years trying to get pregnant, and after multiple miscarriages and infertility issues, it looks like her dream is about to come true – she is seven months pregnant. But a terrible turn of events leads to a nightmare – one that takes away the baby she has already fallen for; and breaks apart her marriage to Max. In the aftermath, she throws herself into her career as a music therapist – using music clinically to soothe burn victims in a hospital; to help Alzheimer’s patients connect with the present; to provide solace for hospice patients. When Vanessa – a guidance counselor -- asks her to work with a suicidal teen, their relationship moves from business to friendship and then, to Zoe’s surprise, blossoms into love. When Zoe allows herself to start thinking of having a family, again, she remembers that there are still frozen embryos that were never used by herself and Max.

Meanwhile, Max has found peace at the bottom of a bottle – until he is redeemed by an evangelical church, whose charismatic pastor – Clive Lincoln – has vowed to fight the “homosexual agenda” that has threatened traditional family values in America. But this mission becomes personal for Max, when Zoe and her same-sex partner say they want permission to raise his unborn child.

SING YOU HOME explores what it means to be gay in today’s world, and how reproductive science has outstripped the legal system. Are embryos people or property? What challenges do same-sex couples face when it comes to marriage and adoption? What happens when religion and sexual orientation – two issues that are supposed to be justice-blind – enter the courtroom? And most importantly, what constitutes a “traditional family” in today’s day and age?"

She raises a great question- what is a "traditional family"? The AFA believes everyone has the right to a family which is why we support everyone in their family building dreams. Jodi wrote this book so she could show her readers families come in all shapes and sizes- love is love. She said when her goal is for reader's to walk away from this book completely understanding why Zoe and Vanessa should be parents- why they deserve to be a family.

I was able to ask Jodi a few questions on infertility and LGBT family building, and will be featuring the interview in The AFA's weekly e-newsletter, Connect. If you don't already subscribe to Connect, please go to our website and sign-up so you don't miss this exciting article!

Friends and Family

By Shari DeGraff Stewart and Julia Fichtner Krahm

Your support can change her life forever as she faces the crisis of infertility treatment.

Each of us can recall with clarity a person who was with us when we were in great pain or need.  Those moments in life stand out like few others.  You, who love an infertile woman, have the opportunity to support her in one of the most difficult experiences of her life.  You cannot change or fix the grief of her infertility, but you can alleviate some of the unnecessary pain that comes inadvertently from those around her.

Men also experience grief and pain during this time, but they have likely not dreamt of being a parent since young childhood.  A woman has been reminded of reproduction every month since puberty, and her life is more affected by other mothers and the talk and experience of children.  Husbands and partners, you will at times share her loss and pain, and other times your experience will be more like that of family and friends—uncertain how to care for and reach out to the woman you love.

One of the most painful experiences of her life
Infertility is consistently described as the most, or one of the most, painful experiences of a woman’s life.  The distress she feels has been shown to be at the same level as those who have cancer or AIDS, and when money is not a factor, it is the most-common reason infertility treatment is discontinued.  What some may mislabel  “obsession” on her part, is single-mindedness necessary for her to endure the emotional, physical, and (often) financial toll of infertility.  Hers is the love of a mother and she is fighting for her child.

Children break all the rules, or “The Fertile Myrtle” response
Because children are so wonderful, we sometimes unintentionally cause her pain by doing or saying things we would know to be hurtful in any other crisis.  Could you imagine if I disclosed to you I had breast cancer, and your response was, “Boy, not me, I’m the healthiest person in the world.”  While you may cringe that anyone would be so insensitive, you would be saddened to know many infertile women have confided their difficulty conceiving, only to be met with a “Not me, I’m Fertile Myrtle.  I get pregnant just thinking about it!”  Likewise we would not boast about a job promotion to someone desperately seeking work, but fail to see that reveling in the delights of our children and grandchildren is equally painful for an infertile woman.

So how do you reach out to and support an infertile woman or couple?
When you realize that infertility is as devastating as any other major life crisis, you will do all of the simple and profound things you would do for anyone who is facing a frightening diagnosis or painful loss.  First, there are just a few “don’ts.”

• Don’t offer advice, especially simplistic statements to “fix” her problem or her emotional distress such as just relax, maybe this was meant to be, or you can always adopt. 
• Don’t pressure her to attend or participate in events involving children, especially baby showers or gift-exchanges.

Do reach out to her often, with cards, words, questions, or invitations to balance the isolation and pain she is experiencing.  Don’t worry that you are going to remind her of her infertility; she hasn’t forgotten it.

• Acknowledge her feelings of grief, loss, anger, or hope:  I am sorry for all you are going through.  This must be so hard for you.  I’d be angry too!  You would be such a wonderful mother.
• If you’re not sure what she is feeling, ask her:  How are you?  Should you go to this event?  What do you need?  Is there anything I can do?  Can I call you after your appointment?  Can I stop by and see you or just sit with you?
• If you feel uncertain, you can always preface your questions with your desire not to pry:  I don’t know if you want to talk about this, but I’m here if you need someone to listen. Is this a good time?  Be sensitive to her response:  if she seems to close down the conversation, then ease back, but gently reach out again later. 
• You can rarely go wrong with cards or messages that say, “I’m thinking about you.”
• Be careful about including children in a visit or conversation.
• Invite her toward activities she finds life giving.  Often the best things are those that offer relationship with you or others and/or movement.  Don’t pressure her or scold her into behavior you think would be helpful. 
• Encourage her to consider her emotional and physical health when she is deciding whether to participate in a social gathering, and protect her by helping her leave if the situation is painful:  You just say the word and I’ll make an excuse for us to leave.
• Husbands/partners:  spoon with her when she’s grieving and don’t try to “fix it.”  Let her know, “We are in this together,” and demonstrate that commitment by doing your own research and participating in medical appointments and procedures.  Double your daily soothing touches, from a simple caress to a massage.  Don’t evade your and her pain by getting lost in work, sports, or the Internet.
• Everyone, remember the logistical difficulties of months or years of treatment:  perform simple errands or chores to allow her to reserve energy for what many women describe as the fight of their life.

For many infertile women, the most-common response from friends and family is... n o t h i n g.  While not your intention, doing nothing can feel like abandonment at a time when she most needs you.  If you can reach out to her in gentle and persistent ways, you can alleviate some of her pain that feels even greater when she is alone.  What you do today, can change your relationship with her forever.

Reprinted with permission from The Stewart Institute for Infertility

 

Miscarriage and the Sense of Personal Failure

by Kim Kluger-Bell, MA, LMFT

Lisa Ling, the former View host, revealed this week that following a miscarriage at 7 weeks into her first pregnancy she felt like a failure, and that she also felt very isolated and alone because no one talked about it. For this reason, she is speaking out and has created a website where women can anonymously share their experiences with miscarriage called Secret Society of Women.

 Ten years ago, when I wrote “Unspeakable Losses: Healing from Miscarriage,Abortion and Other Preganancy Losses” I felt exactly the same way. The silence surrounding miscarriage only makes you feel more freakish and alone. Here is what you need to know about miscarriages:

 Miscarriages are Common

 Approximately one in 5 pregnancies in the US end in miscarriage every year. That means hundreds of thousands of women experience miscarriages every year. And most of those miscarriages occur in the first 12 weeks of pregnancy. In fact, your chance of miscarrying after that time is only 3%.

 Having One Miscarriage Doesn’t Mean You’ll have another

 Most miscarriages, however, are usually random and isolated events. Having one miscarriage only slightly increases your odds of having another one.

 The Emotional Impact can be Devastating

 For many women, the attachment to the child she is carrying begins at the moment she knows she is pregnant. That is when we begin dreaming about the baby we are carrying and imagining how our lives will change in only nine short months. Few of us hold back our excitement due to fears of a first trimester miscarriage. Instead, we start taking extraordinarily good care of ourselves—eating right, getting plenty of rest and avoiding alcohol, caffeine and tobacco products. When a loss takes place despite all of these preparations, you can feel like you did something wrong. Even the word—miscarriage—seems to imply that you did not carry your baby properly.

 It is Not Your Fault

 In many, if not most cases, the cause of your miscarriage will never be known. Again, most miscarrages are random and isolated events. Doctors now believe that at least 60% of miscarriages are caused by chromosomal abnormalities in the developing embryo or fetus, and that another 10% are caused by various uterine abnormalties (most of which can be corrected with surgery). The remaining 30% of miscarriages may be cause by immunological factors, infections or environmental factors (including smoking and heavy alcohol use).

 Recovering from Miscarriage Takes Time

 It is often more difficult to recover emotionally from a miscarriage than it is to recover physically from one. Even if you had to have a D & C, the emotional fallout from a miscarriage can stay with you for months afterward. Guilt, shame, sadness, anger, and a feeling of powerlessness are very common emotions. So is a sense of generalized anxiety and the fear of another loss. It is not uncommon, especially if you are not able to become pregnant again quickly, to have an ongoing awareness of  how far along in the pregnancy you would have been if the loss had not occurred. Many women feel particularly grief-stricken around the time of the due date of that pregnancy. Miscarriage is a traumatic experience—it takes time to heal from a trauma of any kind.

 It is important to be gentle with your self and find people to talk to who are compassionate and will not judge you for the intensity of your feelings. It is also important not to blame yourself, or to isolate yourself too much. It may be impossible to spend much time around pregnant friends or those with babies or young children, but if you don’t have people in your life who are willing to share their own experiences of pregnancy loss with you, there is a large group of people out there who have been through a miscarriage, and there are many on-line resources and books available to you that can help you feel less alone.

 Websites:

• Facebook page, “Whisperers”
• www.nationalshare.org
• www.missfoundation.org

 Books:

• Empty Arms by Pam Vredevelt
• Empty Cradle, Broken Heart by Deborah L. Davis
• Unspeakable Losses by Kim Kluger-Bell
• Miscarriage: Women Sharing from the Heart by Marie Allen, Shelly Marks

Kim Kluger-Bell is a psychotherapist and marriage and family therapist in private practice in Berkeley, California. She specializes in helping individuals and couples heal from such reproductive crises as infertility, pregnancy loss, and abortion. She lives in Albany, California, with her husband and son.

 

 

Betty Jean Lifton Dies

 

By Carolyn Berger, LCSW

Betty Jean Lifton, who was an early proponent of open adoption, died at the age of 84 in Cambridge, Massachusetts on November 19^th.

It’s impossible to talk about the internal world of an adoptee without bringing up Lifton.  She was an adoptee herself and a therapist who worked with all members of the adoption triad—the adoptee, birthparents, and adoptive parents.  She wrote a number of books and is best known for “Twice Born:  Memoirs of an Adopted Daughter,” “ Lost and Found:  The Adoption Experience,” and “Journey of the Adopted Self:  A Quest for Wholeness.”

None of these books is for the faint of heart, but they are undeniably compelling.  Lifton tells us things we might have known about adoption if we were to speak honestly with adoptees from early childhood on.  She tells us about the self of an adoptee who did not know who his parents were or where they came from—the self that sought a kind of wholeness it had been denied-- and the journey this self took toward healing. 

The world of adoption would be very different today if Lifton hadn’t encouraged open adoption and the transparency to which it aspires.  Bringing birthparents and adoptive parents together for the sake of a child is rarely easy, but it allows the child an authentic sense of self which is simply unavailable through closed adoption. 

While Lifton’s books aren’t always easy to read—it can be hard to see the struggles of the adopted self laid bare-- they are immeasurably valuable to us all.

Thank you, Betty Jean Lifton, for all that you have given us.

Carolyn Berger, LCSW is Chair of The AFA Adoption Advisory Board.  She has a private practice in Manhattan and Westchester which is devoted to Fertility, All Forms of Family Building and Adoption.

 

 

30 Seconds and Understanding

by Kevin Hoffman

Below is a letter I recently wrote to my birth mother and below that is what I learned from writing it.

**************

Dear Helen,

I call you Helen because calling you mom just doesn’t feel right.

On October 24, 2009, I found after 21 years of searching and then I lost you.  I found out from an adoption angel via a text message that you had died in 2003.  Sitting on the cold metal bleachers at our local high school watching a football game I found out you died in May of 2003.

I searched my heart to find the right emotion to feel and couldn’t find it.  To that point, you were a stranger to me and I wasn’t sure how I should mourn the death of a stranger.  I really didn’t feel sad.  I was more disappointed than anything.

Over the last year, I have had some time to sort things out, but the right emotion still doesn’t register.  When I think of my wife or my boys, I immediately get powerful emotions that fill my heart.  When I think of you, it just goes blank.

Part of the reason I think I was so hesitant for many years to look for you was because I feared being rejected by you…again.  I think even in death I still feel that.  I feel rejected because you never spoke about me to ANYONE.  When I ask your daughter/my biological sister, or your best friend what you said about me, they both say the same thing.  You never talked about me.

It is my understanding your death was not a sudden death.  I can’t help but wonder why in those last months, weeks, and days, you didn’t speak of me.  How come you didn’t leave a message for me or tuck away in a private place something that you wanted me and only me to have.  How come you didn’t take 30 seconds to tell someone that I mattered?

There are days when I think the separation from me was just too painful to talk about and I try to spin it in a positive light.  Then there are days when I think, that you just didn’t care.  As a father, I can’t understand that.  I can’t conceptualize how that is possible; how you can have a child roaming the earth somewhere and not care or think about them.  I have no evidence that you did and more evidence that you didn’t.

In this past year, I have struggled with telling myself over and over that I matter; that I am important; that I am worthy.  I artificially construct and build up my self esteem that could have been raised to an all-time high if you would’ve taken 30 seconds to whisper to someone your regret.  Instead, I am left to do as have always done from as far back as I can remember; fantasize.

My imagination fills in the holes created by you that you were meant to fill.  My creative mind tells me you suffered in silence and thought about me on my birthday, and on Labor Day, Thanksgiving, Christmas, New Year’s Eve and New Year’s Day, Memorial Day, The 4^th of July, and again on my birthday in August.  Reality tells me I have nothing to support this fantasy.

Like a child on Christmas looking for that one special gift that isn’t there, I still wait and hope in some chest, some book, in your personal belongings somewhere, someone will find a letter written to me that kills reality and awakens fantasy.

These are the feelings, that surround me today and guilt drips from my fingers as I type these words.  As an adoptee, I have learned really well to protect others around me often at the expense of my own feelings and thoughts.  So I wrestle with guilt and push it into the nearest closet so I can express what I need to protect me.  I needed only 30 seconds and I have a right to those 30 seconds.

Kevin

When I posted this to my blog, many parents commented about what they thought my mother was thinking or how proud of me she would be, or how they felt my pain in the letter.

I sat back, as a parent and understood why so many felt the need to comfort me and encourage me.  As parents, we want to erase any hurt and pain our children are experiencing and through the many comments I received I saw that and understood it.

I also learned as a parent sometimes our children just want to be heard and understood.  In this letter that is what I wanted.  I appreciated the desire from so many to make me feel better but I really just wanted someone to acknowledge that the joys of adoption can also bring pain; pain that has to be worked through not fixed today.  I learned that sometimes, as a parent we just have to hold our children and agree that the circumstances of life just plain suck and we can’t do anything about it but try and understand.  

Kevin Hoffman is the author of GROWING UP BLACK IN WHITE, the poignant memoir of a mixed-race child adopted by a white family in Detroit during the country's turbulent times of racial unrest, and the joy of embracing his identity.  Learn more at http://www.kevinhofmann.com  

 

A Baby at Last

 

by Carolyn Berger, L.C.S.W.

As those of you who religiously follow the AFA Blog know, Wednesday night’s

Illuminations NYC fundraiser was a remarkable success.

 My favorite part of the evening was giving Dr. Zev Rosenwaks, Dr. Marc Goldstein, and Mark Fuerst our Media Award for their recent book, A Baby at Last.

 If truth be told, I was just a bit anxious before getting up in front of our 170 guests. Would I suffer from “brain freeze,” forget someone’s name, or, even worse, trip on the step up to the stage?  To make matters even more dicey, I decided a minute before I went up that I wouldn’t follow my script, but would speak from my heart instead.  I just didn’t feel that what I had written was enough.

 So I got up there and told people that after I finished reading the first chapter of the book, “You Are Not Alone,” I knew I had to get a second copy.  I counsel fertility patients in two separate offices, and I wanted this book by my side in both places. It would make me a better therapist.

 I’ll tell you why.  The book takes the very complex world of fertility treatment and simplifies it—something that patients and clinicians alike can appreciate.  It intersperses scientific information with vignettes of true-to-life couples struggling to have babies—and it imparts hope.  Each chapter ends with “Take-Home Messages,” which cull the essential ideas and can act as quick reference points for busy patients who don’t have time to re-read chapters looking for one important piece of information.

 Something else I like about the book…. In a world where female fertility issues often take center stage, Dr. Zev Rosenwaks and Dr. Marc Goldstein, both of Weill Cornell Medical Center, have joined together to give male and female fertility equal play, including chapters on both male and female fertility evaluations and treatments. (This is all to the good since while male and female factors each count for 40% of cases of infertility, male-factor infertility has not gotten the attention it deserves.)

 So, my introduction of our Media Honorees went just fine in the end.  Dr. Zev Rosenwaks took out a sheaf of papers when he reached the podium—and then put them aside.  He spoke from his heart instead.  Dr. Marc Goldstein did the same. And Mark Fuerst followed suit.

 It was just that kind of evening, hopeful and celebratory all at once, and when I went home I was smiling.

 Carolyn Berger, LCSW, is Founding Board Chair of The AFA.  She has a practice devoted to Fertility, All Forms of Family Building and Adoption in Westchester and Manhattan.

 

Black, In A Family of Whites

 

by Kevin Hofmann

I was and still am a minority in my own family. 

I was the product of an affair between my white mother and black father and for obvious reasons, I was given up for adoption immediately after I was born.  My biological mother transported me from the hospital to my foster home and that was the last time we saw each other, 43 years ago.

Three months later, I was adopted by a white minister, his wife, and their three biological children.  It was the fall of 1967 in Detroit, just three explosive months after the riots that changed the city forever.

Growing up in Detroit at such a time was a mixture of childhood bliss and adult conflict.  There were often times this powder keg of emotion was swirling around me and I was oblivious to it all.  My parents shouldered a large majority of the racism and struggle that our colorful family faced.  This is not to say that I didn’t see any of it because I did and I was very aware of my color and the negative attention that can come with the additional melanin in my skin.

Fortunately, in the early 70’s and 80’s, Detroit became the perfect storm for me.  Because of the riots, the whites were leaving the city rapidly and the city, its neighborhoods, and schools were quickly becoming predominately black.  This assured that I would always see another face that looked like mine on a daily basis.  Because of that, I became very comfortable with who I was as a black child and learned about a culture in a way that my parents couldn’t teach me.  My racial identity and pride came through osmosis.  I sucked it in from the black children around me.

 As I stated, my childhood was not without struggle.  When I was eight, we moved to a new neighborhood in Detroit; a neighborhood that hadn’t felt the color shift, just yet.  I was the first child of color on our block and immediately the white children I played with let me know I was different.  This was an alarming change for me because the neighborhood I came from was all black.  Now I had to deal with being the different child.  It was tough and uncomfortable but the pride that was injected into me by my black friends from the old neighborhood and at school everyday gave me a solid foundation to weather this storm.

 Growing up as a transracial adoptee has been a unique experience. In the end, I consider it a positive one and I spend my professional time speaking to adoption professionals and adoptive parents to share what my parents got right and what they could have done better. 

 It is not an easy lifestyle and because of that I am a conditional supporter of transracial adoption.  It is not something for everybody.  So I am very passionate about letting anyone interested in transracial adoption know the challenges, the struggles, and also the joy that can come from growing up black in a family of whites.

   

Kevin Hofmann is the author of  Growing Up Black In White. http://www.kevinhofmann.com

Fall is (almost) here! Can The AFA's Fertility and Adoption Directory be far behind?

by Corey Whelan

Despite the fact that New York City school children are not yet back in school, summer really is whispering goodbye.  I can't believe it's Labor Day Weekend.  Heat wave notwithstanding, sunscreen bottles will eventually get relegated to the back of the medicine cabinet, and weekend excursions to view the fall foliage will be planned.  And for many, dreams of becoming a family will once again take center stage after a summer's mental hiatus.

Every summer, The AFA staff finalizes the finishing touches on our year long labor of love, the annual AFA National Fertility and Adoption Directory.  It's an important book.  In this era of quick internet searches, the Directory gives men and women who are in pursuit of family the opportunity to sit, relax, and read.  To learn.  To breathe into their plans a little bit.  To luxuriate in the knowledge that the information they are reading is cutting edge, first rate, and most of all, trustable.  As a non profit, patient advocacy organization, that's who we are.  That's what we give.

This year's book is about What's New.  What do you need to know, to build your family now?  Articles in this year's edition will focus on a vast array of topics, including (but not limited to):

• • The Initial Consultation - Dan Potter MD
  • Elective Single Embryo Transfer - Mark Bush MD
  • Egg Freezing and Vitrification - John Schnorr MD
  • Weight and Infertility - Joel Batzofin MD
  • Unexplained Infertility - Richard Sherbahn MD
  • Bicornate Septum - Fred Licciardi MD
  • Herbal Solutions to Thyroid and Infertility - Stacy Roberts
  • Hypnois and Infertility - Joanne Verkuilen
  • What's New in the world of Urology - Philip Werthman MD
  • Vasectomy Reversal - Harry Fisch MD
  • Varicocele and Infertility - Stan Honig MD
  • Separate but not Equal - Ken Mosesian
  • Complete Informed Consent - Cyndi Gross
  • Marriage Equality - Thersa Erickson Esq.
  • Growing Up Adopted - Marni Denenberg
  • Pregnancy Interupted - Emily Laitmon, LCSW
  • PGD - Kathleen Miller
  • Cord Blood Banking - Wendy Spry RN
  • Attachment Disorder and Adoption - Carolyn Berger LCSW
  • Surrogates and Health Insurance - Steve Snyder Esq.
  • LGBT Adoption Laws - a State by State Guide
  • Premature Puberty - Danny Shapiro MD
  • Some of my own articles on being pregnant and on being a mommy after infertilitiy

Oh Lord, there's more.  This is about half.  It will be a good book.

And like all AFA publications, this book on cd is free to consumers.  Which is a really good thing.  Because not only are we giving (thanks to our wonderful authors) amazing information to our readers, we are also supplying in print, our practice network lists of providers, state by state.  More comprehensive and easier to read than ever, we will list physicians, attorneys, lgbt friendly providers, therapists, complementary specialists, a bunch of others.

Did I mention that the Directory is free?  That it is printed in book form, and on cd format and hangs on our website for a year?  And doesn't cost consumers anything?  

We'd like to thank the Directory advertisers, the savvy professionals who opt to support our work through these pages.  They are:

• A Baby at Last
• A Jewish Blessing
• Adoptions From the Heart
• Advanced Fertility Center of Chicago
• Agency for Surrogacy Solutions, Inc.
• Alliance for Children
• AlphaCord
• Ambulatory Care Pharmacy
• Ametz Adoption Program
• Apthorp Pharmacy
• Ascend Specialty Rx
• Associated Services for International Adoption
• Attain FertilityTM Centers, an IntegraMed Specialty and provider of the Attain® IVF Programs
• Beth Israel Medical Center, Department of Urology
• BirthRoad Surrogacy Specialists
• Bob Bamman, LCSW
• California Cryobank, Inc.
• Carolyn Berger, LCSW
• Center For Advanced Reproductive Services
• Center for Male Reproductive Medicine and Surgery, Cornell Institute for Reproductive Medicine
• Center for Reproductive Health
• Center for Reproductive Medicine
• Circle + Bloom
• CNY Fertility Center
• Coastal Fertility Medical Center
• Colorado Reproductive Endocrinology
• Conceiveabilities
• Conceptions Reproductive Associates of Colorado
• Conceptual Options
• Dave Thomas Foundation for Adoption
• Disney/ABC
• Donor Network Alliance
• Donor Services
• Ellen Speyer, MFT
• Emily Laitmon, LCSW
• Erickson Law
• Fairhaven Health, LLC
• Family Acuity
• Family Creations, LLC
• Fertility Centers of Illinois
• Fertility Counseling Services
• Fertility Cryobank
• Fertility Physicians of Northern California
• Fertility SOURCE Companies
• Fertility Specialists of Houston
• Forever Families Through Adoptions
• Genesis Fertility and Reproductive Medicine
• Genesis Genetics Institute
• Genetics & IVF Institute
• Global IVF, Inc.
• Greenwich Fertility Center
• Growing Generations
• Happy Beginnings, LLC
• Harris M. Nagler, MD, FACS
• Heartfelt Egg Donation
• Houston IVF
• HRC Fertility
• IntegraMed Specialty Healthcare Services
• International Assisted Reproduction Center
• IVF Florida Reproductive Associates
• IVF New Jersey
• Izetta Stern, LCSW BCD
• Jewish Child Care Association
• Jeanette Moy, MS, LAc
• Jennifer Thie, MD LLC
• Joan Winograd, LCSW
• Joann Paley Galst, PhD
• Judith Greenwald, MSW
• Julie M. Tavoso, Esq.
• Kings Pharmacy
• LA Baby
• La Jolla IVF
• Law Offices of Julie M. Tavoso, LLC
• Lois Nachamie, LCSW, BCD
• Lotus Blossom Consulting, LLC
• Madeline Licker Feingold, PhD
• Madison Women's Health & Fertility, PC
• Marc Goldstein, MD, DSc(hon), FACS, Center for Male Reproductive Medicine and Surgery, Cornell Institute for Reproductive Medicine
• Margot Weinshel, LCSW, RN
• MDR Pharmaceutical Care
• Mindy Berkson, Infertility Consultant
• Miracles Egg Donation
• Missouri Center for Reproductive Medicine & Fertility
• Nancy Kaufman, LCSW, LP
• National Fertility Law Center, Inc.
• New England Fertility Institute
• New Life Agency
• Open Arms Consultants
• Oregon Reproductive Medicine
• Pacific Fertility Center of San Francisco
• Pacific NW Fertility and IVF Specialists
• Parenting Options Through Surrogacy, Egg Donation and Adoption
• Patricia Mendell, LCSW
• Peas in a Pod
• Penn Fertility Care
• Peter N. Schlegel, MD, FACS, Center for Male Reproductive Medicine and Surgery, Cornell Institute for Reproductive Medicine
• Prime Genetics, LLC
• Prospective Families
• Reproductive Care Center
• Reproductive Endocrinology Associates of Charlotte
• Reproductive Medicine Group
• Reproductive Medicine Associates of New York
• Reproductive Medicine Associates of Philadelphia
• Reproductive Possibilities, LLC
• Reproductive Resource Center of Greater Kansas City
• Reproductive Science Center of New England
• Reproductive Specialists of New York
• Rockville Centre Pharmacy
• Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine of Weill Cornell Medical College
• Ross & Zuckerman, LLP
• Rumbold & Seidelman
• Sandra Schoeneman, PhD
• SCSA Diagnostics, Inc.
• Shady Grove Fertility
• Silvia Schneider Fox, PsyD
• Spence Chapin
• Steven H. Snyder & Associates
• Strong Yoga4Fertility
• Surrogacy Center
• Surrogate Alternatives, Inc.
• Surrogate Parenting Services
• Susan Frank, LCSW
• The Center for Reproductive Medicine
• The Dave Thomas Foundation for Adoption
• The Reproductive Medicine Group
• The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine of Weill Cornell Medical College
• The Surrogacy Center
• Tiny Treasures New England
• University Reproductive Associates
• Village Fertility Pharmacy
• West Coast Surrogacy
• Westchester Reproductive Medicine
• William Petok, PhD
• Worldwide Surrogacy Specialists

   Pretty impressive list.  And no, we couldn't do it without them.  And yes, we are grateful, as are the consumers who benefit from these pages.

The AFA is currently accepting pre-publication orders of the Directory on cd, for consumers only.  (Professionals can pick up a copy at The AFA booth at ASRM).  If you would like to request your free copy of the Directory, please let Lisa know.  [email protected].  She will get you a copy as soon as the presses stop running.  

Enjoy the beach this weekend my friends. 

 

Graphic Art courtesy of Mindi Sarko

Men, Sperm Donors, Children and Research

By William D. Petok, Ph.D.

A recent Op-Ed piece in the New York Times by Russ Douthat, The Birds and the Bees (via the Fertility Clinic), has raised a variety of interesting issues that bear closer inspection. Mr. Douthat suggests that children who are adopted and children produced via assisted reproductive technology (ART), particularly third party gametes, are equivalent.  One could make the weak argument that this is the case because both may be unaware of one or both of their genetic origins. But adopted children have to deal with the fact that they are “given away” and that is not the case with children born from ART, whether it is donor gamete or surrogate gestational carrier.

Mr. Douthat’s column covers a piece of “research” reported by the Institute for American Values that purports to provide data collected from “younger adults, ages 18 to 45, who were conceived through sperm donation. The authors — Elizabeth Marquardt, Norval Glenn and Karen Clark — depict a population that’s at once grateful to the fertility industry and uneasy about the way they were conceived, supportive of assisted fertility but haunted by the feeling of being a bought-and-paid-for child.” The original paper was not published in a peer reviewed professional journal, the gold standard for scientific research.  And the organization that funded it is conservative in nature and appears to be biased against ARTs. One of the authors is a donor-conceived adult who was 18 when she learned the truth about her conception when her father passed away. We don’t know how she feels about this. Either way it could bias her view on the subject. Good research should be unbiased.

Others have commented on the usefulness of the paper, most notably Todd Essig, Ph.D., a psychologist who specializes in fertility matters and Rachel Gurevich, a health writer with personal experience with infertility. The Letters to the Editor of the Times also provide some additional feedback.  They all note that it is important to learn about the thoughts and feelings of children born from ART. And they caution that complex questions such as the interior lives of people require thoughtful and careful study. The paper Douthat writes about is not nearly complex enough to accomplish this. These writers also question the certainty with which Douthat reports the findings and question the study’s authors’ conclusions.

Certainly, a good understanding of how to interpret research is necessary to evaluate whether or not a study is credible and what flaws may be contained in it. Since most of us aren’t trained to evaluate scientific research, writers who report on it should take pains to explain the limitations so that a lay person can make a reasonable judgment about the value of what is being reported. Douthat does not do this.

Finally, what Douthat fails to address in his article is the significant use of donor sperm. And here I believe he is missing an opportunity to create awareness as important as the feelings of children conceived through donor gametes.  He could have addressed the frequently overlooked statistic that approximately 40% of infertility is male factor. Yet there are no “spokesmen” for this problem, it’s not very “sexy” and therefore gets little recognition in the press and slides under the radar of many. How valuable would it be for a writer with Douthat’s distribution to bring this fact into the general consciousness?  Failing to do so perpetuates male infertility in the shadows and prevents some men and the culture in general from addressing it in a forthright manner.  I’d rather see Mr. Douthat using his valuable space in the Times to raise our awareness of this important matter than giving coverage to questionable and probably biased research.  But that’s just my opinion!

William D. Petok, Ph.D. is a a licensed psychotherapist based in Maryland and a member of The AFA’s board of directors

Intended Parents: Miracles Do Happen (A Mother's Day Story)

by Sandra Watson Rapley

After years of struggling with infertility and feelings of hopelessness my brother Clive and sister-in-law Victoria offered Victoria to be our surrogate mother. My husband Craig and I were extremely happy with their offer but we never ever thought we would have to take them up on it. I still held on to the hope that I would become pregnant and that my body would not let me down. Another IVF attempt failed and after some time of coming to terms with the fact that I could not have children, we decided to accept Clive and Victoria’s extremely generous offer. We wondered how it would work out because Clive and Victoria lived in California and Craig and I lived in New Jersey.  In the end there was no reason to worry about this.

The IVF procedures we’d been through confirmed that I could produce eggs and they could be fertilized by my husband’s sperm so having a child genetically related to both of us was still a distinct possibility. After completing the required medical testing, psychological evaluation, and legal aspects, we were ready to start. Clive and Victoria have two children and did not want any more children so that requirement by our fertility center was met.

We flew out to California for the egg retrieval. Six eggs were retrieved and I had high hopes that they would all fertilize in vitro. Out of six only two fertilized and made it to day three. Having gone through prior failed IVF treatments with more embryos I began to feel despair. Surely it would fail again. We hoped and prayed that at least one of the embryos would implant. A week after the transfer we found out that Victoria was pregnant! We could not believe it. I was in complete shock. Six weeks later we found out that we were pregnant with twins! We felt so fortunate and grateful that both embryos had implanted. We were also lucky enough to have the sonogram recorded on a video cassette. Craig and I watched it over and over again.

Victoria suffered with pre-term labor and extreme morning sickness. Fortunately I had a flexible job which allowed me to work anywhere as long as I could communicate by telephone and by email.  So at week 16 I had already flown to California for one of the doctor’s visits when I had to rush Victoria to the emergency room because she started to feel contractions. One of the better parts of being in the ER was that they had very sophisticated sonogram equipment so we were able to view a very clear and detailed sonogram which revealed that we were having two boys! She was immediately put on bed rest at week 16 and would remain this way until the babies were born.

Throughout the pregnancy we were filled with every emotion in the book – from worry to happiness, and from feelings of guilt to joy. I rushed Victoria to the emergency room on another occasion when the fear of early delivery scared us again. I decided to fly out and stay with them for the rest of the pregnancy. When I saw Victoria she looked grey. I had never seen her look this way before.

It was during this time that I realized how bad her morning sickness was. I was racked with guilt and teary eyed every time she got up from the couch and waddled to the bathroom. I would sit there and wonder why on earth she had offered to do this for us. She assured me that she knew exactly what she would have to go through. She suffered terribly with morning sickness during her pregnancies with her own children. It was then that I understood why it was a requirement of the fertility center that a surrogate mother should already have children.

Fortunately for us, Victoria managed to carry our babies until week 36. Our fraternal twin boys were delivered by C-Section and weighed 6lbs 15oz and 5lbs. I will never forget when they came into the world – kicking and screaming. I was able to be in the delivery room and I saw exactly how and when they came into the world. I was filled with shock, joy, and fear. After the boys were swaddled they were handed to me and both my arms were filled. A new worry came over me when I began to wonder how I would feed them at the same time. Craig arrived the following morning and saw our babies for the first time. He asked “Where have you been? We have been waiting for you”. Our sons are healthy and strong and are now eight and a half years old.

Clive and Victoria - thank you both for your extreme generosity and kindness.

Sandra Watson Rapley is also the author of “Intended Parents: Miracles Do Happen”