Scientists grow viable vaginas from girls’ own cells

CHICAGO (Reuters) — Four young women born with abnormal or missing vaginas were implanted with lab-grown versions made from their own cells, the latest success in creating replacement organs that have so far included tracheas, bladders and urethras.

Follow-up tests show the new vaginas are indistinguishable from the women’s own tissue and have grown in size as the young women, who got the implants as teens, matured.

All four of the women are now sexually active and report normal vaginal function. Two of the four, who were born with a working uterus but no vagina, now menstruate normally.

It is not yet clear whether these women can bear children, but because they are menstruating, it suggests their ovaries are working, so it may be possible, said Dr Anthony Atala, director of Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine in North Carolina.

The feat, which Atala and colleagues in Mexico describe in the journal the Lancet, is the latest demonstration from the growing field of regenerative medicine, a discipline in which doctors take advantage of the body’s power to regrow and replace cells.

In prior studies, Atala’s team has used the approach to make replacement bladders and urine tubes or urethras in young boys.

Atala said the pilot study is the first to show that vaginal organs custom-built in the lab using patients’ own cells can be successfully used in humans, offering a new option for women who need reconstructive surgeries.

All four of the women in the study were born with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent. Conventional treatment generally involves the use of grafts made from intestinal tissue or from skin, but both tissues have drawbacks, says Atala, a pediatric urologic surgeon at Wake Forest.

Intestinal tissue produces an excess of mucus, which can cause problems with odor. Conventional skin, meanwhile, can collapse.

Atala said women with this condition usually seek treatment as teenagers. «They can’t menstruate, especially when they have a severe defect where they don’t have an opening,» he said. This can cause abdominal pain as menstrual blood collects in the abdomen. «It has nowhere else to go,» he added.

Girls in the study were aged 13 and 18 at the time of the surgeries, which were performed between June 2005 and October 2008.

The researchers started off by collecting a small amount of cells from genital tissue and grew two types of cells in the lab: muscle cells and epithelial cells, a type of cell that lines body cavities. About four weeks later, the team started applying layers of the cells onto a scaffold made of collagen, a material that can be absorbed by the body. They then shaped the organ to fit each patient’s anatomy, and placed it in an incubator.

A week later, the team created a cavity in the body and surgically attached the vaginal implants to existing reproductive organs. Once implanted, nerves and blood vessels formed to feed the new organ, and new cells eventually replaced the scaffolding as it was absorbed by the body.

«By the six-month time point, you couldn’t tell the difference between engineered organ and the normal organ,» Atala said.

The team continued to monitor the young women, taking tissue biopsies, MRI scans and internal exams, for up to eight years from the initial implants.

All of these tests showed the engineered vaginas «were similar in makeup and function to native tissue,» said Atlantida-Raya Rivera, director of the HIMFG Tissue Engineering Laboratory at the Metropolitan Autonomous University in Mexico City, where the surgeries were performed.

Professor Martin Birchall of UCL Ear Institute in London, who wrote a commentary in the same journal, said the findings address some important questions about tissue-engineering, including whether tissue will grow as patients grow and whether an organ as large as the vagina can develop blood vessels when implanted in the body.

Surrogacy Struggle

Washington: Following two hearings earlier this month, advocates for gestational surrogacy are continuing their push for two bills that set forth standards for gestational carrier agreements, hoping to sway reticent or cautious legislators to their side.

The House and Senate versions of the Collaborative Reproduction Act — sponsored by Del. Kathleen Dumais (D-Montgomery Co.) and Sen. Delores Kelley (D-Baltimore Co.) — both attempt to set forth guidelines for who can be a gestational carrier, meaning a person who carries a pregnancy to term but who is not genetically or biologically related to the child being born. Both bills define requirements for who can serve as a gestational carrier, and put in place a number of safeguards, including mental health screenings for the carrier, her partner or spouse, and the intended parents, and a provision requiring each party to get separate legal representation that will represent their best interests.

There are no guidelines governing gestational surrogacy under current Maryland law, although the practice was implicitly approved by the courts in a 2003 case where the Maryland Court of Appeals overruled a lower court decision refusing to allow a gestational carrier to remove her name as the mother from a birth certificate. Maryland still presumes that the gestational carrier is the mother, but that presumption can be rebutted.

The measures were heard in the House of Delegates’ Judiciary Committee on Feb. 12 and the Senate Judicial Proceedings Committee on Feb. 18. Throughout the House hearing, advocates for collaborative reproduction — including lawyers who work with gestational carriers, reproductive specialists and mental health professionals — testified on behalf of the bill, educating lawmakers about the technical aspects of the topic. But many lawmakers seemed to lack an understanding of the bill, or posed questions that appeared to be aimed at derailing the measure in order to curry favor with socially conservative groups who oppose the concept of surrogacy in any form.

Several delegates repeatedly expressed concerns over the possible exploitation of gestational carriers under such agreements, but Dumais repeatedly reiterated that such exploitation would be prevented by setting up standards and model framework for agreements between intended parents and gestational surrogates. Because Maryland lacks any statute governing the matter, lawyers and medical professionals who work with gestational carriers have no binding legal requirements placed on them, although many adhere to best practices and professional standards as set forth by groups like the American Society for Reproductive Medicine.

Advocates pointed out that even if the bill were not to pass, gestational surrogacy has been — and will continue to be — practiced.

“The issue is not whether or not collaborative reproduction exists, but the most appropriate legal framework and whether best practice will be used to structure the process,” said Dr. Joyce McDowell, who explained the type of mental health screening that all parties to collaborative reproduction must undergo.

The biggest sticking points in the deliberations over collaborative reproduction are several amendments added to a similar bill last year. One such amendment was so burdensome and egregious, it prompted Dumais to pull the bill. That amendment would have required a court to approve a gestational carrier agreement beforehand, which Dumais objected to because approving such a provision would have made Maryland the only state to require a court to approve a contract prior to the parties entering into it. Other amendments  attached to last year’s Senate bill deal with provisions on abortion or liabilities.

As the House hearing progressed, it became obvious that some delegates were opposed to the bill, concocting a variety of scenarios where something could go wrong or where there was a disagreement between the intended parents and the gestational carrier, even though both House and Senate versions set up provisions that require all parties to undergo mental screening and meet prior to any implantation of a fertilized egg to discuss what the expectations of those involved are. Delegates who have previously sided with the Catholic Conference in their opposition to social issues such as abortion and marriage equality raised a myriad of objections, peppering witnesses speaking in favor of collaborative reproduction with questions ranging from issues like determining parentage to which party would bear the medical costs associated with the pregnancy, even raising the specter that insurance companies might one day refuse to cover such procedures.

Opponents frequently sought to conflate the issue of gestational surrogacy with traditional surrogacy, where the carrier has a biological link to the child, or with egg donation. Some even seemed unfamiliar with the concept of surrogacy in general. Still others objected to a provision in the bill that would list the intended parents as the child’s parents on the birth certificate. At one point, Delegates Susan McComas (R-Harford Co.) and Geraldine Valentino-Smith (D-Prince George’s Co.) even alleged that Shady Grove Fertility Center, one of the leaders in gestational surrogacy was coercing or trying to lure women with the promise of money for serving as a gestational carrier on its website, something later proven to be false by freshman Del. Vanessa Atterbeary (D-Howard Co.).

Conservative-leaning members also raised the issue of abortion or selective reduction, which can sometimes happen when a woman is implanted with one or two eggs via in vitro fertilization. Although lawyers and medical professionals who work with gestational carriers noted that a match would not be made if the carrier and intended parents did not agree on what to do in a variety of scenarios, other witnesses, including the Catholic Conference and Maryland Right to Life, insisted that the law, as written, has too many loopholes that can lead to the exploitation of women serving as gestational carriers. Andrea Garvey, testifying on behalf of the Maryland Catholic Conference, even alleged that the bill would do nothing to prevent child trafficking or the targeting of financially vulnerable young women to serve as gestational surrogates, leading to a heated exchange with Dumais, particularly after she accused Dumais of being unwilling to listen to their concerns. Garvey insisted that several amendments, including the ones passed by the Senate last year, be added to the bill.

The Senate hearing, by contrast, was more low-key. Since the committee had previously voted to pass similar bills during the past three legislative sessions, there were fewer witnesses and many fewer questions asked by senators. At that hearing, supporters of the measure did note that, despite claims from the Catholic Conference that they did not outright oppose the bill, the Vatican has generally opposed any and all forms of assisted reproduction such as in vitro fertilization, the only method by which gestational surrogacy may occur.

Even though gestational surrogacy is commonly practiced in the state of Maryland, getting lawmakers to pass legislation could be an uphill battle. The goal of advocates is to pass a bill that hasn’t been significantly altered by “compromise” amendments so as to be unsalvageable, as was the case with last year’s Senate bill. The trick will be for those supporting collaborative reproduction to convince lawmakers that the bill will implement the necessary safeguards to protect all parties involved, rather than unleashing a Pandora’s box of social ills.

Dumais, as the chief House sponsor, said she will be sending around a memo to her fellow committee members and her Senate counterparts that outlines what sort of amendments would be acceptable and which would be considered “poison pills” that would doom the fate of the collaborative reproduction measures. She said she already has an opinion from former Attorney Doug Gansler (D) supporting the framework for gestational carrier agreements, and will seek a similar opinion from the office of current Attorney General Brian Frosh (D).

“The provision that would require judicial review by a circuit court judge, which was one of the amendments to the Senate bill last year, truly is a poison pill,” Dumais told Metro Weekly. She noted that only one state — Virginia — has a statute where a court may sign off on the gestational carrier agreement prior to the parties entering into the agreement, but it also contains an option to “opt out” of or circumvent that part of the process, which is almost always utilized in cases of gestational surrogacy.

Dumais said another “non-starter” amendment was a proposal to force the state Department of Health to create a registry of surrogacy agencies, which was also slipped into the Senate bill last year as a “compromise” to conservative lawmakers without any debate in either chamber, or without hearing any testimony in favor or against creating a registry.

“A number of lawmakers seemed concerned about the way in which gestational carriers are recruited,” Dumais said. “But that’s an entirely different issue. If you hate surrogacy agencies, put it in a separate bill.”
Dumais will also offer suggestions for friendly amendments that could generate support for the bill without changing its overall intent, including a provision, desired by Maryland Right to Life, that specifically states that intended parents cannot force a gestational carrier to have an abortion against her will, even if they wish to withdraw from the agreement, something that Dumais called “fine and completely appropriate.” She expressed support for a tighter and revised definition of what constitutes “reasonable medical and ancillary expenses” that must be covered by the intended parents.

Jennifer Fairfax, an attorney specializing in reproductive law testified in favor of the House bill and took an optimistic view of the hearings and promised to work with Dumais and other lawmakers to craft appropriate amendments that will make the bill’s passage possible.

“I was actually pleased that the delegates were asking questions, and trying to figure out what is going on with the bill,” she says. “I think it also informed us, as supporters of the bill, what they’re looking for and what friendly amendments we can make to get support for the bill. The hearing, at least to me, demonstrated that we need to get more information to the General Assembly. We need to show that this is all about protecting children born through gestational surrogacy.”

Fairfax also noted that the bill’s length, breadth and its very scientific and highly detailed terminology, as well as the fact that it delves into a niche area of law that is not familiar to most people, could have added to some confusion on the part of lawmakers.

“This is creating an entire new law, from soup to nuts,” she says. “It’s a good bill. It’s meant to protect kids, and I’m really optimistic that the legislature will pass it this year.”
http://www.metroweekly.com/

Govt to prepare laws over surrogacy

Ireland: The Government has agreed to prepare new laws to regulate surrogacy and the broader area of assisted human reproduction and associated research.

The aim of the proposed legislation is to bring to an end the legal uncertainty in which these services currently operate.

Cabinet authorised the Department of Health to prepare legislation targeting a range of practices including surrogacy, embryo donation, embryo screening and stem cell research.
Health Minister Leo Varadkar said: "The priority throughout will be to safeguard the welfare, safety and best interests of children and to uphold the principles of consent and equality."

Submissions from interested parties are to be invited as part of a public consultation process.

The Joint Committee on Health and Children will also be invited to hold public hearings on the matter and subject the draft legislation to scrutiny.

Speaking on RTÉ's Morning Ireland, Mr Varadkar said it will be difficult to put the legislation through before next year's election.

Mr Varadkar also said he envisaged that under the legislation parentage could be transferred to the genetic parents without the need to go through the adoption process, once there is agreement with the surrogate.

The minister added that commercial surrogacy would be banned under the legislation, although reimbursement of expenses will be permitted.

Anyone that wishes to become a surrogate will be required to go for counselling beforehand, and there will be age limits.
Separately, Minister Varadkar also said "it only stands to reason that lives could be lost" as a result of delays in receiving hospital treatment.

Mr Varadkar said the issue of delayed discharges of patients from hospitals is a serious safety issue, adding it is a long-standing feature of Ireland's dysfunctional health service and continues to be a big problem.

Details released to RTÉ's Prime Time under the Freedom of Information Act showed that the HSE's former National Director for Acute Hospitals Dr Tony O'Connell warned last September that delayed discharges were putting lives at risk.

Mr Varadkar said the issue was not new and had been well known and well documented, and had been spoken about many times by both himself and Minister of State Kathleen Lynch.

He said it was something the Government had tried to address in part with a €25 million package of additional nursing home places and home care packages but said what has been done to date hasn't been enough.

Mr Varadkar said there was research from other countries which clearly demonstrates that long trolley waits and delayed discharges result in increased mortality.

The Minister said he was sorry to see Dr O'Connell depart, but that the issue of delayed discharges was not the reason for his resignation.

Figures today show that there are 479 patients on trolleys in Emergency Departments or wards, waiting for admission to a bed.

The worst affected hospital is Beaumont in Dublin with 52 patients waiting.

Other hospitals badly affected are: Our Lady of Lourdes in Drogheda and University Hospital Galway, each with 40 patients waiting.

Letterkenny General has 38 patients waiting.

Today's figures represents a reduction on yesterday's overcrowding figure of 514.
http://www.rte.ie/

THERE IS NO ABSOLUTE INFERTILITY!!!

BioTexCom is one of the best centers for human reproduction in the world. Visiting BioTexCom clinic infertile couples from all over the world receive the most favorable conditions in particular 100% guarantee that the medical program’s result will be positive. Not every European clinic can vaunt of such conditions. But we will return to this point later, and now all in good time.

BioTexCom center was founded in the Ukrainian capital, Kiev, by a German citizen. Mr. Albert Totchilovski has gathered rich European experience and combined it with the unique skills of the Ukrainian doctors. Members of a friendly and professional BioTexCom team use the best medical practices and put into life dream of a child of thousands infertile couples. Doctors who work in the BioTexCom center get a leg even in the most hopeless cases of infertility. Programs and methods used in this clinic are thought over in such way that clients receive only positive result not paying the extra money.

Basic techniques with the help of which BioTexCom doctors achieve positive results:

·         Embryologists work with fresh genetic material (eggs/sperm cryopreservation is used only at patient’s will). Such approach automatically multiplies chances for the successful fertilization. It is known and proven that quality of eggs is worsen during the freeze process leading to the failed IVF attempts;

·         In addition to the spermogram doctors conduct sperm analysis for apoptosis. Conducting this medical test embryologist determines presence of the damaged sperm cells which prevent successful conception and can cause child’s DNA damage. In the case of cells’ poor quality, doctor prescribes appropriate medication (it improves the quality of problem spermatozoid), afterwards perform reanalysis and successfully fertilize the egg;

·         Karyotype analysis is the part of a standard analyzes set (karyotype test shows the total number of chromosomes, the sex of the person being studied, and if there are any structural abnormalities with any of the individual chromosomes which can cause child’s diseases);

·         Conducting programs of the egg donation and surrogate motherhood doctors calculate the ideal "window of implantation" - the most successful period for the embryo transfer without disturbing its structure and endometrium integrity;

·         Starting to work with the infertile couple, our specialists use only individual approach in each case. First of all, members of the medical staff carry out detailed diagnostics of patients in order to identify clearly the seeds of the disease or reasons of the unsuccessful IVF attempts. There are no identical protocols as BioTexCom team does not work in the traces - positive result of any medical program is our main goal;

·         Doctors of the Kiev center walk the line of the latest methods of treatment. So, for example, embryologists use the most successful method of working with blastocysts, namely, embryo transfer on the fifth day. It greatly increases the chance of pregnancy during the in vitro fertilization programs.

The Surrogacy Program covers all the bases and works in the clients’ favor. Unlike other European clinics, the surrogacy program cost in the BioTexCom is significantly lower and service is better than in the high-level medical centers. Depending on diagnosis, doctor can recommend surrogacy program with donor or own eggs. Patients pay for the program on a phased basis:

·         signing the contract;

·         before the pickup / puncture procedure;

·         when surrogate mother reaches 12^th week of pregnancy;

·         as act of delivery starts;

·         during the final stage of the program, when biological parents receive all necessary documents and leave the clinic with the newborn.

Signing the contract, clients receive a complete package of services. In particular, BioTexCom drivers meet patients at the airport and provide them with a transfer from/to the clinic, hotel, embassy, etc. Clients live in the clinic’s homes, hotels which are regularly visited by pediatrician who specializes in the newborn children. Doctor monitors condition of the newborn’s health, advises parents on all issues they are interested in. In the case of premature birth, BioTexCom covers all the expenses concerning necessary medications, procedures, and child’s stay in the hospital if it will be needed. During the whole period of the program manager and translator accompany couple and organize all processes, coordinate patients, prepare all documents and help clients to go through the program without difficulties. Interpreters who accompany clients are accredited to work in the state institutions, as well as have an experience on working with the documentation for the surrogacy (Ministry of Justice, Ministry of Foreign Affairs). All services listed above are included in the price of the program you choose.

The Program of Egg Donation. Every day dozens of women who want to become egg donors come to the BioTexCom center. Our specialists choose candidates carefully. Potential donors go through the numerous medical examinations and work with a psychologist.  Only 2 - 3 of 10 ladies who wish to become the egg donor enter the program. Our donors are attractive, healthy women with higher education, and they will be worthy to become donors of the biological material for you.

Couple receives the following information about the donor, eggs of whom will be used in the program: nationality, height, weight, eye and hair color, education, family and children, blood group and Rh factor. According to the Ukrainian law, egg donors cannot take upon themselves parental responsibilities with the respect to the future child. Parties sign an agreement, which defines all the rights and obligations of the contract parties. Candidate for the donation procedure undergoes a full health check and has a talk with a psychologist. BioTexCom reproductive medicine center has a great base of the best egg donors and is the biggest supplier of cells in Europe. A lot of countries buy eggs in Ukraine in order to use them conducting the IVF procedures at home.      

Center For Human Reproduction BioTexCom – your best choice for the surrogate motherhood and egg donation! There is no absolute infertility! BioTexCom clinic knows it for sure and continues to improve methods to deal with the infertility.

Choose the best medical package for you!

BioTexCom

Center For Human Reproduction

http://mother-surrogate.info/services/

Couples have more options with surrogacy

At just 28 years old, Nicole Lawson found herself unable to sustain a pregnancy.

While attempting to have a child of her own, she went through four years of procedures such as in-vitro fertilization. She suffered multiple miscarriages only to discover that she had a severe uterine abnormality.

The situation led her and her husband to opt to eventually have two daughters via a surrogate.

Today, Lawson is not only a mom, but the co-owner of Abundant Beginnings Company, a full-service surrogacy agency with locations in Los Angeles and the San Francisco Bay area.

“As for many, my infertility was a dark period in my life,” she said. “For me, surrogacy was the best option because I was able to produce high-quality eggs but simply not able to carry a fetus.”

While the number of families who seek surrogates to carry their babies is hard to gauge, the percentage of couples turning to this option may be on the rise. A 2010 report from the nonprofit Council for Responsible Genetics, citing data from the Centers for Disease Control and Prevention and the Society for Assisted Reproductive Technology, shows the number of babies born via surrogates practically doubled between 2004 to 2008 from 738 to 1,400.

Dr. Wendy Buchi, a San Diego gynecologist and physician partner with IGO Medical Group, said recent data shows roughly 1 percent of those who go through in-vitro fertilization use a surrogate.

Among those who bring babies into the world using surrogates, she said, the majority fall into one of three categories: those who don’t have a functional uterus, such as those born without a uterus; those whose uterus is scarred or damaged from disease; or those who had their uterus removed while fighting cancer, for instance.

There are also women with medical conditions that make it dangerous to attempt pregnancy, including heart defects or certain types of kidney problems, or those on medications that could harm a baby such as chemotherapy for cancer. In addition, there are women who’ve exhausted all other options. These couples often have viable sperm and eggs, but can’t carry a pregnancy to term.

Dr. Buchi said some parents-to-be have a surrogate in mind such as a friend or relative, but most opt to use someone they don’t know.

Saira Jhutty, CEO of San Diego’s Conceptual Options, a surrogacy agency, said to be matched with a surrogate, questions are asked of both parties. Many then meet in person or via Skype, but the majority meet face-to-face.

She said her agency has roughly 30 active surrogates in its database. In general, women who want to be surrogates have already had at least one full-term pregnancy of their own and they must be in good health. They – and their spouses, if they are married – must also be tested for sexually transmitted diseases.

At agencies such as Conceptual Options, Jhutty said only about 4 percent of women who are interested in serving as surrogates are accepted. Before being added to the agency’s database, potential surrogates must also meet with an in-house psychologist for a six- to eight-hour evaluation, and their medical records are sent to an IVF center to be reviewed and screened.

http://www.utsandiego.com/

Surrogacy: how the law develops in response to social change

Yesterday, Claire Legras, a distinguished member of the Conseil d’Etat in France and rapporteur for the National Consultative Ethics Committee for Health and Life Sciences, contributed her perspective on the ethical considerations of surrogacy. Her piece, which posits national court case as global problem, underscores the value of discussions between judges in other jurisdictions facing similar problems. Today, Lady Justice Arden explores the international dimensions of surrogacy law, including differences in approach between French and English law. 

In its recent decision in Mennesson v. France (App no. 65192/11), the Fifth Section of the European Court of Human Rights in Strasbourg ruled that surrogate children—in this case, born in the US and having US citizenship—should not be prevented from registering as French citizens, as this would be a violation of their right to respect for their private life. The Strasbourg court’s view, which is very understandable, is that nationality is an important part of a person’s identity.

The Strasbourg court’s view, which is very understandable, is that nationality is an important part of a person’s identity.

France has not asked for this decision to be referred to—and thus reconsidered by—the Grand Chamber of the Strasbourg court. So it will be interesting to see whether, or to what extent, the French legislature or the French courts take account of this decision.

In Mennesson, the child was the biological child of one of the commissioning parents. In the more recent case of Paradiso and Campanelli v. Italy (App. no. 25358/12), the child was not the biological child of either of the commissioning parents; born abroad, the baby was removed from their custody on return to Italy. Strasbourg also found a violation of the child’s right to a private life in that case.

Other Convention states are also considering whether to revise their law in order to focus on the best interests of the child. Finland, for instance, is considering modifications to the ban on domestic commercial surrogacy. The Federal Supreme Court of Germany has held that an order of a Californian court, which declares the commissioning parents to be the parents of the surrogate child, should be recognised in Germany (BGH, 10 December 2014, XII ZB 463/13).

These cases demonstrate how courts across Europe are increasingly having to deal with surrogacy issues, and how those issues have now taken on an international dimension. Society is undergoing great change in its acceptance of reproductive autonomy and liberty.

It would be impossible to summarise English law on surrogacy in a few sentences. Here are some key points.

1. Agencies: Surrogacy agreements are unenforceable and agencies that make surrogacy arrangements on a commercial basis are prohibited in England, according to sections 1A and 2 of the Surrogacy Arrangements Act of 1985. That drives commissioning parents abroad.

These cases demonstrate how courts across Europe are increasingly having to deal with surrogacy issues, and how those issues have now taken on an international dimension. Society is undergoing great change in its acceptance of reproductive autonomy and liberty.

2. Parental orders: When the commissioning parents return with a newly-born child that is biologically theirs, they should apply to the English court for a parental order under section 54 of the Human Fertilisation and Embryology Act 2008 within 6 months. The English court will decide whether it is in the best interests of the child to give parental responsibility to the commissioning parents. The recent Strasbourg case law may, therefore, not cause any immediate difficulty.   The 2008 Act provides that at least one of the commissioning parents must be domiciled in the UK at the time of the application for the parental order. The court has held that it must take account of the commissioning parents’ good faith; it must consider whether any offence has been committed, and it is an offence to bring a child into the jurisdiction following a foreign adoption order. The court has also held that the commissioning parents do not commit this offence where the adoption order was made to meet the requirements of the court dealing with the surrogacy arrangements.

3. Birth mother’s consent: The consent of the birth mother must be proved and is ineffective if given less than 6 weeks after the birth.

4. Surrogacy payments: Before making a parental order, the court will also need to consider and authorise any payments which have been made for the surrogacy arrangements ,and which exceed the payment of the birth mother of her reasonable expenses.

5. Liberal interpretation: The courts have applied a liberal interpretation to the statutory requirements: they have to decide whether to make a parental order in the light of the fact that the child has been born and is a fait accompli. The President of the Family Division has, for instance, held that Parliament must have intended that an application for a parental order could be made outside the 6-month period (re X (A Child) (Surrogacy: Time Limit) [2014] EWHC 3135).

6. Role of the courts: The role of the English court requires a high level of judicial skill, but there is a detailed statutory scheme and the role of the judge is therefore very specific.

English law is pragmatic: it proceeds on the basis that there is no turning back and that the legislative framework is not a perfect solution to the issues of surrogacy.

The English courts’ role is far removed from that of the Cour de Cassation in France in deciding whether to apply ethical public policy considerations in the field of nationality, as it did in Mennesson.

7. English law is pragmatic: it proceeds on the basis that there is no turning back and that the legislative framework is not a perfect solution to the issues of surrogacy.   English law is not driven by any single public policy aim but by several aims: the policy of not permitting commodification of the human body through commercial arrangements (while not preventing purely altruistic arrangements), protecting the child’s best interests, and safeguarding the interests of the birth mother. The courts and Parliament seek to balance these considerations, and it is, on occasion, difficult to do this.

Claire Legras’ contribution brought me to realise how valuable it was to discuss legal problems with judges and practitioners in other jurisdictions. The value of the international perspective was one of the themes in my recent book, Human Rights and European Law (OUP, 2015), volume 1 of a 2-part series Shaping Tomorrow’s Law. Our appreciation of the problems facing us and the quality of our own law is enriched as a result.

There is another point. The reaction in France to Mennesson shows that the UK is not the only Convention state to experience, from time to time, difficulties and challenges to our deeply held beliefs as a result of advances in human rights.   Whatever the strengths and weaknesses of the Convention system, the Strasbourg court is the place where there is an attempt at mediating the diverse views in Europe on ethical issues. The Strasbourg court cannot solve the problems of surrogacy from every angle, but it can survey the legal scene in the Convention states (as it did in Mennesson), and address key issues in this field.


This is a consequence of the Strasbourg court’s conception of the Convention as “a living instrument.” Its dynamic approach enables the law to develop in line with social changes. Our own common law contains similar mechanisms, and how it addresses social change is one of the themes in volume 2, Common Law and Modern Society: Keeping Pace with Change, which will be published later this year.
http://blog.oup.com/

Surrogacy: The difference a due date makes

The UK Government has finally changed the law to allow parents of children born through surrogacy the same rights to leave and pay as other parents. However, rather than bring the new law into effect immediately, the Government has only applied it to babies 'whose expected week of birth begins on or after 5 April 2015'. This presents some problems, not least because, as I describe below, the difference in employment rights for intended parents is vast.

Some couples I have advised find themselves in the situation of one day having the benefit of the new law and then a few weeks later having that option removed. A second scan, for example, changes their baby's due date from 7 April 2015 to 2 April 2015. Suddenly, their employer is no longer obliged to allow them any leave to care for their newborn child (and all the added benefits, such as keeping their job open, that other parents enjoy).

A genetic father is arguably entitled to two weeks paternity leave, but cannot take advantage of additional paternity leave unless the surrogate fulfils certain conditions about when she terminated her maternity leave. Other than that, parents of children born through surrogacy go from having the same rights as other parents to having at best an entitlement to discretionary unpaid leave (known currently as parental leave) for 18 weeks only.

Some intended parents are told by their employers they are only able to take annual leave, giving them a matter of weeks to care for their newborn child before having to return to work. The impact of a change of due date around the beginning of April is therefore huge, not only on the parents of children born through surrogacy, but also on the child.

I am not a scientist, nor a healthcare professional of any kind, but my own experience has taught me due dates are not always accurate. Neither of my children were born remotely close to their due dates and would be considered late term. I have also been told by couples that despite being very sympathetic, midwives (who agree due dates are not that reliable) say they are unable to change an updated due date following a scan.

A little internet research has lead me, and couples I have spoken to, to see that there are a number of different methods used to estimate a baby's due date. As a rule of thumb, women are told their due date is 40 weeks from the first day of their last period, but this based on an assumption of every woman having a 28-day cycle and ovulating on the 14th day of her cycle. This method may be used to give an initial due date but ultrasound scans may then alter the date. There is a difference of opinion as to whether scans performed later into the pregnancy (during the second and third trimester) should lead to a change in the due date, and this decision may depend on the size of the discrepancy between the estimated due dates.

What does seem to be clear is that the due date is an estimate only, borne out by statistics which show only a very low percentage of babies are born on their due date. I have advised intended parents to talk through this issue with their midwives and doctors, but often parents are only aware of the issue after the due date has changed - and this could leave healthcare professionals in a difficult position if they are asked, for example, to change a due date that has been written on a MATB1 form.

My view remains that the current law, which provides little or nothing by way of employment rights for parents of children born through surrogacy, may be unlawful. That said, bringing a successful legal challenge is difficult, not least due to the costs involved and the inherent risks in litigation. Thankfully many employers are sympathetic and forward thinking, and after brief negotiation agreements can be reached. Sadly this is not always the case and the impending change in the law now poses a new problem for intended parents.

Bring on 5 April 2015 and the start of proper equality for all parents and their newborn children!

 http://www.bionews.org.uk/

Professionalise surrogacy, say New Zealand academics

Two New Zealand academics have proposed that surrogacy become a profession like nursing or teaching which is fully integrated into the health system. Writing in the journal Bioethics, Ruth Walker  and Liezl van Zyl, of the University of Waikato, contend that both commercial and altruistic surrogacy have so many potential moral, legal and emotional complications that a complete change in the framework is needed.

Their discussion centres on decisions about whether to abort a surrogate mother’s foetus if there is a substantial abnornamlity. It would be unethical for commissioning parents to request abortion for a minor abnormality like a cleft palate, but in cases of severe abnormality, “abortion would be the morally responsible thing to do”.

Often, however, the intending parents and the surrogate mother quarrel over the fate of the baby. In a commercial model, parents often demand that the baby be aborted, which treats the surrogate as a mere vessel and denies her right to bodily  integrity. In an altruistic model, the intending parents can just walk away if there are problems, leaving the mother with the baby or the decision whether to abort.

What the authors proposed is the creation of a professional cadre of registered surrogates working within a government instrumentality, with set fees and civil servants who can support the mother and parents if there are difficulties. “The professional model emphasizes the ethical dimension of surrogacy,” they believe.

“ … payment should not be tied to the delivery of a healthy infant. Although many critics of commercial surrogacy claim that it is the payment itself that is pernicious, we argue that the flaw lies in the way payment is managed. For example, in cases where the surrogate agrees to an abortion she should still receive full payment so that she is not penalized for doing the right thing. The intended parents are not buying a baby but (committed) service, which may include an abortion. Her financial situation should not be a factor in her decision whether to have an abortion.

"Further, in the professional model the intended parents would be the legal parents from the moment the baby is born. This ensures certainty for both parties, and best serves the needs and interests of the child. The intended parents should not be able to abandon the baby any more than the surrogate should be able to withhold it from them."

See Our New Video

http://mother-surrogate.info/

A second child through surrogacy in BioTexCom

Video  http://mother-surrogate.info/a-second-child-through-surrogacy-in-biotexcom/

Hello we are gathered here to hear a story from our dear clients. They came for a second child. And I want to ask you about your experience from your first attempt, and, what is your intention right now? So, please, just tell what do you think about BioTex.

Well, my experience with BioTex was amazing! One year ago, approximately, I was given a diagnosis of a very serious disease, because of which there is no way for me to have children. The adoption process is very difficult in Spain, moreover if you have some problem – a serious disease. So, I started to look for a solution, started to think if we can start the process in United States, Canada, Mexico… But the options did not seem to be adequate for us. Because, Mexico, because it is too far and because there is no provision for the surrogate motherhood, or so called “womb to rent”, in the legislation. Because it seems that the surrogate mother can not be remunerated, there is no provision in any law, and you can not sign any contract with such provision. That`s why we started to consider the eastern part, Russia and Ukraine. And, due to economic factor, which is also so important in our time, and because of the crisis, we decided to trust in BioTexCom and undertook the adventure, and went directly to Ukraine, where we were met in a wonderful way.

What can you tell about BioTexCom service? What do you like, the accommodation, the food? Is it good enough for you?

Very important for me was the fact that I got all kinds of services. So that I did not have to look for something at my own expense, nor have to be bothered by looking for some services. BioTex gives you all the kind of services: food, accommodation so you don`t have to worry about this. The food is not the same as in Spain, but it is still fine.

Thank you. What can you tell about the “All-inclusive” package? Why did you choose to go here and to choose this package?

In our case we chose the unlimited attempts because it gave us guarantee which we were expecting. There are other clinics and other packages, which offer you attempt by attempt, but, you don`t really know the total sum of money which you will have to pay at the end. And for the middle class the most adequate option is to have a program with a fixed price. That`s why we decided for this program. It is amazing in this meaning.

Can you tell something about how the process went? Were you successful from the first attempt?

We were so lucky because we had gone through all the process approximately in 11 months. Since the moment we signed the contract up to the success passed 11 months. And we were so lucky to succeed from the first attempt. So, we can not ask for more. We have our baby, who is healthy and strong, and we are happy about that.

So you were very lucky from the first attempt. So, can you tell me why you have chosen to go exactly to Ukraine? Not to for example United States, or Russia? Because it is also allowed in Russia and United States.

Well, I have to say that the character of Ukrainian people in some aspects is pretty like the character of Spanish people. They have nothing to deal with Russians, though they have the same origin. But in certain characteristics they are like us. And in Ukraine I have felt myself at my second home. The language really is an inconvenience, of course, but this kind of problem  can be solved. And Ukraine can offer you all kind of guarantees which can be offered by any European clinic or any clinic of United States. They do all kind of tests that are done in Spain during pregnancy, like a trisomy test ,which is done on the 12th week of pregnancy to detect any kind of defects, or all the ultrasounds, which would be done in Spain. So there is enough guarantee. If we are talking about the war which is now, I can say, according to my own experience, that in Kiev there is no glimmer of war or any hostile environment. You can come to Kiev with no worry, without any problem and…perfect.

Thank you, so, can you tell something to our new clients about your surrogate mother? Because a lot of clients are interested in the surrogates: how they look like, are they good or are they some kind of not really healthy persons? Can you tell something about your surrogate mother?

Well my surrogate is a person who I don`t know that deeply, cause we were not staying in touch during all the process, cause we were in Spain and she was here. But I got to know her and she is a normal person, healthy, and she was doing it voluntary. Talking about health, I can say that she has a great health, because my son`s health is great. Physically she is clean, very discreet and well-mannered girl. Well, like any person, like 90% of people, she is a normal person.

Thank you. So, what do you expect from your next attempt? 

Well, we expect to have the same luck as we had the first time, and, well, in this attempt we expect to get a boy or a girl, will see if we succeed from the first time. And if we have to do more attempts, well we will. We are with the program with guaranties, so that we are on firm ground.

Okay, can you tell something about documentation process? I mean, were there any problems? Or it was smooth?

Well, in our case we had no problems with the document stuff. Because all the documents were prepared perfectly and our kid from the very beginning had his Spanish passport and family book, and everything was calm. Nobody even tried to stop us while we were crossing the border.

Okay, thank you. And, maybe, final question: what can you tell to Spanish couples that want to go to BioTex? Some couples are just afraid to go to Ukraine. Is the situation now stable? Can the couples go? Like you are right here, right now, so what can you say? So they don`t need to be afraid to come. 

Well, I can say that you don`t have to be afraid to come to Ukraine and that there is a total provision for the surrogate motherhood in the legislation. This is a topic which is prohibited in Spain now. We are expecting that it will change in future and will be accepted. Well, and you can walk on the streets with no problem, be in some mall, have a cup of coffee with no worry. And is exaggerated all what you can see on TV about the war, about Ukrainians dying.  Yes, really there is a war, but it is on the borders, far enough from Kiev. And you don`t have to be afraid to come. The thing is that Kiev will give you the most beautiful what you can have in your life – your son or daughter.

Thank you!  

Free Online Seminar! March 12, 2015

BioTexCom managers will answer all your questions concerning surrogacy and egg donation during the video – chat.
English speaking managers of the Center for Human Reproduction BioTexCom will held the web conference on March 12, 2015 (Thursday) from 16:00 to 17:00 Kiev time (GMT + 2) which will take place on the clinic’s official web site. Meeting online in a real time is a unique opportunity for the infertile people to get acquainted with the assisted methods of reproductive medicine, and ask any questions with the regards to the surrogacy, egg donation, procedure stages, donors’ selection, legal issues and many others. English-speaking managers who daily work with foreign clients and lead the programs will help you to understand all the tricks of modern reproduction. You need only to write your question in the chat.

Rules of participation in the webinar:

1. Visit the official website of the clinic BioTexCom http://mother-surrogate.info/;
2. Click on the box “webinar” on the home page;
3. Click on the link you will see after clicking on the “webinar” box;
4. Fill in your name;
5. Welcome! You are in the video – chat! Here you can write any question related to the programs of reproductive medicine, and our manager will answer you in the mode of video conferencing. Thus, we will see only question in the chat, and you will be able to see and hear the manager and her answers.

NOTICE!!! The nearest BioTexCom Webinar will be held on March 12 , 2015, 16:00 – 17:00. Link to the participation in the online – seminar will be active only during this hour. Follow the latest clinic’s news and follow our webinar!

Feel free to ask your questions concerning our webinar biotexengland@yahoo.com

We offer a free initial consultation

http://mother-surrogate.info/

Commercial surrogacy is a rigged market in wombs for rent

Since the disgraceful Baby Gammy case last year, in which an Australian couple left a twin boy with his birth mother when it was discovered he had Down’s syndrome, Thailand has banned foreigners and same-sex couples from accessing surrogacy services. Now only married heterosexuals are allowed to use surrogates, with at least one of the couple required to be Thai. No one is allowed to gain financially from the transaction.

But will this shift in legislation put an end to the inherent abuse in what can be described as womb trafficking? I doubt it. In order to put a stop to this increasingly normalised practice, we need to understand the reality of what surrogacy entails.

Commercial surrogacy breeds exploitation, abuse and misery. Although the poster girl of surrogates is typically a white, blonde, smiling women who is carrying a baby in order to make a childless couple happy, the truth is far less palatable.

Women in the global south are often pimped by husbands and criminal gangs into renting their wombs to rich western couples. For women in India for example, this is a particular problem. I have interviewed rich, white British gay couples who told me they chose India for surrogacy services because it was considerably cheaper than the US (where the surrogacy business is booming), with one couple admitting it was reassuring that the women are required to live in a clinic for the duration of the pregnancy so they can be monitored by the “brokers” throughout.

Gestational surrogates are required to take Lupron, oestrogen and progesterone medication to help achieve the pregnancy, all of which treatments can have serious side effects.
Class and racial divisions between surrogates, egg donors and the intended parents are often stark. Surrogates tend to be working class and to have already had their own children, whereas the egg donor will likely be a college graduate from an upper-class background who is considered bright and attractive. They generally earn significantly more than the surrogates.

While the gestational surrogates tend to be poor women disadvantaged in many ways, egg donors are often chosen (from catalogues) for their “strong genes” and lack of mental and physical ill health in their lineage. The process is not that far removed from eugenics.
Many agree that it is unethical to buy and sell pregnancy but support what is known as altruistic surrogacy. This is where a friend, relative or kind stranger bears a child for an infertile woman or couple simply out of the goodness of her heart.

The argument goes that if we do not accept altruistic surrogacy and put measures in place to regulate it, we will drive commercial surrogacy underground. But the opposite is true. The legal sanctioning and social acceptance of this practice, even where no money changes hands, will further perpetuate the notion that the wombs of poor women can be used as a service.
As in Thailand, the law has been changed in India, another popular spot for British couples seeking commercial surrogacy. Now it is required that prospective parents looking to engage a surrogate must be a “man and woman [who] are duly married and the marriage should be sustained at least two years”.

Alongside many feminist and human rights campaigners, I wish to see an end to commercial surrogacy and a serious, honest discussion about the ethics of all forms of outsourcing pregnancy, particularly in a world awash with unwanted and neglected babies and children.

We also need to pose a challenge to the increasing numbers of gay men who think it perfectly acceptable to use the womb of a desperate woman in order to reproduce. Indeed, this method of making babies is fast becoming the number-one option for gay men, which means the practice will become more normalised, and be seen even as a “right” for those who cannot conceive in the traditional manner.

However, the Thai and Indian ban on same-sex couples from accessing surrogacy is nothing short of discrimination and anti-gay bigotry. An end to this harmful practice in all but private, one-to-one circumstances would be what true equality looks like.
http://www.theguardian.com/