Frozen eggs for IVF resulted in fewer successful pregnancies

American Society for Reproductive Medicine has published results of a new study conducted in order to compare success rates of IVF cycles with the use of fresh and frozen oocytes. The research team investigated outcomes of the two IVF techniques during the year.  

Results of the study confirmed previous comments made by the reproductive medicine community representatives with regards to the eggs cryopreservation: “Although analysis of literature shows that cryopreservation technique is effective for women who need it for medical reasons we cannot use it widely to plan pregnancy".

Recent studies have shown that only 34% of 12,000 IVF cycles with frozen donor eggs ended in a successful pregnancy. While 79% of programs with fresh oocytes resulted in normal pregnancy and live birth.

Scientists note that the main reason for failure results of IVF programs with frozen biological material is poor quality of cells after their thawing. Carrying out numerous experiments and researches, experts explain: "IVF with cryopreserved eggs resulted in fewer live births. It’s much better to use fresh oocytes in order to reach successful pregnancy and live birth. During cells’ thawing their structure is damaged. In addition not many cells survive. Doctor can even not to see deformation of cells immediately, but in future it could lead to various diseases and abnormalities of child".

Women who freeze their own eggs in order to postpone fertility “are generally not infertile, but most are not as young/healthy as carefully screened egg donors,” expert explained, so he would anticipate pregnancy rates among women who freeze their own eggs to “depend largely on their age, health, the number and quality of eggs frozen, and the quality of the IVF center/lab where the procedure takes place.”

In recent years, an increasing number of women have used donated eggs for IVF. Donor eggs’ popularity has been growing from year to year. Many European countries buy donor cells in Ukraine to carry out IVF programs at home. Ukraine is recognized as one of the best donor cells producer, because there this procedure is legal and there is a low living standards in Ukraine. Egg donation programs make thousands of young, healthy women possible to sell clinics own qualitative cells for infertile couples from Europe.

Surrogacy in the UK vs Surrogacy Abroad – entirely different, or one and the same?

2015 has already seen a number of surrogacy judgments1 which challenge the law as it currently stands in relation to this increasingly mainstream pathway to parenthood.  However, where the issue at hand is whether a parental order should be made2, the focus historically has been on international arrangements.  Whilst contentious UK surrogacy cases, happily, remain remarkable (and therefore likely published), these and international arrangements overshadow the reality and prevalence of the undisputed UK surrogacy arrangement.  Though uncontentious in nature, such arrangements are commonly peppered with comparable issues to those found in overseas applications, though the latter remain in the realms of the High Court3.  It is not denied that international surrogacy arrangements are naturally hazardous and necessitate a cautious approach at court level, but, as demonstrated below, UK arrangements come with equal risks.

The practice of surrogacy in the UK
Repeatedly overshadowed by uncertainty as to the surrounding legalities, surrogacy is in fact very achievable in the UK and arrangements take place in their hundreds every year.  However, due to the lack of an overtly supportive legal framework, its practice varies widely and the resulting disparity between arrangements can be vast.

Often the best option, for those who have the choice, is to use a surrogate who is a family member or close friend.  Arrangements where trust is implicit invariably make for the most altruistic and straightforward.  For those who need to look elsewhere there are a number of independent organisations which facilitate arrangements between prospective parents and surrogates4, by enabling introductions and supporting the resulting relationships.  However, a growing method of establishing a surrogacy arrangement is to look online.  The increase in social networking has enabled prospective parents to find a willing surrogate (and vice versa) through Facebook groups and online forums, where regulation is scarce and support informal.

The risks of working with a previously unknown surrogate (or indeed prospective parents) are obvious, but some arrangements forge ahead with a surprising lack of communication to determine the other side's true motivations.  As surrogacy agreements are not legally binding in the UK, there is no obligation or obvious trigger for prospective parents to meet with a lawyer at the outset.  Although it is not possible to draft an agreement on their behalf (this is an offence for professionals5, though something the parties are encouraged to do amongst themselves), a consultation at this stage provides an opportunity to set out the legal position and explain what must be done to reassign parenthood in due course.  Some parents are made aware of this and seek initial advice; others are not and will proceed having had no professional input (sometimes without any written agreement in place at all).  Though not enforceable, parents and surrogates can agree whatever they wish in terms of payments, restrictions and obligations during pregnancy, contact before and after birth and any other matters they consider important.

There is also a choice of how to conceive.  If no fertility procedure is strictly required6, and particularly if cost is an issue, it is not unusual for conception to take place via artificial insemination at home.  This not only throws up further issues as to the surrogate's investment and attachment to the pregnancy, but by not having treatment at a licensed UK clinic parents and surrogates do not benefit from the built-in counselling and professional support provided before conception.

Oversight of surrogacy in the UK
It is easy to see how the lack of structure and obligatory professional oversight here can lead to a culture of casually-set-up surrogacy arrangements based on hopes of aligned intentions and well-placed faith in the unknown.  In the absence of a robust UK legal system to fall back on, for those arrangements where problems do arise, a lack of guidance and support from experienced professionals can exacerbate matters and put the relationship of the parties under considerable strain.  Even where these issues do not affect the outcome of the arrangement7, they can cause difficulties during the subsequent court process.

The parental order process8 provides the first formal oversight that many arrangements will see, though this comes too late across the board, since there can be no application until the child is born (leaving him or her legally vulnerable for a period of at least several weeks).  It is at this stage that the applicant parents are faced with conforming to the parameters set by section 54 of the Human Fertilisation and Embryology Act 2008; some of whom will not already be familiar with the requirements.

Whilst applications following UK surrogacy are dealt with relatively straightforwardly in practice, the ambiguous surrogacy backdrop in this country provides the potential for just as many legal quandaries to arise as do so in cross-border surrogacy arrangements.  The difference lies in the level of scrutiny of the two.

Common issues arising following international surrogacy arrangements and how they pertain to UK arrangements
The recent case of R and S v T (Surrogacy: Service, Consent and Payments) [2015] EWFC 22 clearly highlighted the flaws associated with pursuing international surrogacy and retrospectively endeavouring to make it compliant with the parental order criteria.  In this case Mrs Justice Theis was particularly concerned over the issue of:

Payments – including what precisely was paid to the surrogate,

Consent – including whether the surrogate had a complete understanding of the consent papers signed and their wider meaning, and

Service – including whether the requirement to serve within the FPR 2010 could be dispensed with.

Though this case is not remarkable in its facts, nor the issues raised, those without practical experience of domestic surrogacy arrangements may be surprised to learn that the above are not unique to international arrangements.

Payments
Section 54(8) of the Human Fertilisation and Embryology Authority Act 2008 states that payments of no more than expenses reasonably incurred should be paid for a surrogacy arrangement, unless authorised by the court.  We know from the plethora of published judgments that the discretion to authorise is widely exercised to subsequently approve commercial payments (both to surrogates and agencies) in overseas surrogacy arrangements.  Given the delicate balance which must be struck between UK public policy stance on commercial surrogacy9 and a child's need for legal stability (via the parental order), this exercise of discretion is currently reserved for High Court judges.  Re L (A Minor) [2010] EWHC 3146 (Fam) established that a child's welfare is the paramount consideration in applications of this nature and Mr Justice Hedley went further to paint the scope of this paramountcy by stating that unless there was the clearest case of the abuse of public policy, a parental order could not be refused on the grounds of payments made (assuming welfare arguments supported its making).  This approach has subsequently been taken in each comparable application.

Despite this flexibility, UK surrogacy seemingly operates independently and invariably under the guise of 'reasonable expenses only' arrangements.  Some UK arrangements are entirely altruistic with minimal or no payments passing between the intended parents and the surrogate.  However, many arrangements see parents making lump sum payments in the region of £8,000 - £16,000 in addition to a separate allowance for expenses directly to their surrogate10.

Unlike within international parental order applications, there appears to be little appetite at local family court level to scrutinise the nature and purpose of the payments made.  The above figures have been routinely accepted by family court judges as representing reasonable expenses over the last few years, with minimal further enquiry as to how the sums paid are broken down and justifiable as expenses.

Some may argue that, by their very level, payments in international arrangements should be scrutinised and, if appropriate, authorised.  However, in practice, the sums paid to foreign surrogates are usually of similar amounts to those paid to UK surrogates.  By way of example, California has a reputation as the most well-established surrogacy destination overseas, by virtue of its openly professional surrogacy industry and robust legal framework.  It is also well known as being the most expensive surrogacy destination.  Yet surrogates there receive on average $25,000 - $35,000 compensation.  At current exchange rates11 this equates to approximately £16,000 - £22,500; directly comparable to the £8,000 - £16,000 (plus expense allowances) commonly paid to UK surrogates.  There is no doubt that such UK arrangements provide the surrogate with more than her out of pocket expenses, a great deal more in many cases12.  The situation remains that similar figures (and sometimes less – if destinations such as the Ukraine, Georgia and India are considered) are subject to close scrutiny and an authorisation exercise in the High Court following international arrangements, where they are almost rubber-stamped as reasonable expenses without the need for authorisation at local family courts following UK arrangements.

Consent
Section 54(6) of the the 2008 Act sets out that the surrogate (and her husband, if she is married) must freely, with full understanding of what is involved, agree unconditionally to the making of the parental order more than six weeks after birth.  There are obvious inherent concerns where foreign surrogates have signed consent paperwork which is not in their native tongue13, particularly if they are then impossible to contact for further clarification.  However, the means of clarifying UK surrogates' consent is not without its flaws.

The standard form A101A used to obtain consent is basic and drafted in such a way that it is presumed the surrogate is a social parent in addition to a legal parent.  Although there are similarities in the function of a parental order to that of an adoption order14, genuine surrogacy arrangements are fundamentally different – the child never having been conceived as a child of the surrogate, nor parented as such.  The form does not go far in terms of informing the signer of the wider meaning of the parental order or indeed to clarify full, free and unconditional consent.  Undoubtedly a clear benefit of UK applications is that CAFCASS (in the form of a parental order reporter) are able to take a more active role in obtaining surrogates' consent15; by visiting them at home and facilitating their understanding of the process in conjunction with obtaining their consent via the A101A.

The six week 'cooling off' period means that the arrangement has been honoured long before the parental order reporter makes their visit and at a time when the surrogate is settling back into her usual family life.  In addition to consent from the surrogate, it is also necessary to obtain the consent of her husband if she is married16.  This can become an awkward, and often protracted, issue if the couple are separated (though not divorced) and particularly if there is any animosity or difficulty in communication between them – a common scenario.

It is rare for surrogates in the UK to obtain legal advice – either prior to entering an arrangement or in relation to the parental order at a later stage17.  This does not seem to be a concern at court level, due largely to the reliance on the parental order reporter to have made a recommendation for a parental order only if he or she is satisfied of the surrogate's full, free and unconditional consent.  Whether this is a burden beyond the call of CAFCASS is subject to debate.

However, whatever the verdict of CAFCASS, it may be that a UK surrogate has just as basic an understanding or unconcern of the court process as a foreign surrogate.  Though, in the same vein as the issue of payments, this is rarely queried further to determine the extent of consent given or whether it is ongoing. It could be argued that the economic disparity between UK parents and foreign surrogates prompts further enquiry as to a surrogate's true understanding and stance – though US surrogacy arrangements18 are similarly scrutinised.  The question then remains why UK surrogates (or at least their wider position) are not probed further and, if they were, whether their consent would always be deemed full, free and unconditional at first scrutiny using the same factors as those considered in international applications.

Service
The service of parental order application forms, acknowledgment forms and notices of proceedings can prove fiddly even in US surrogacy arrangements where documents do not need to be translated and can be emailed directly to the respondents19.  Following the provision of formal consent, the service and completion of more documents can appear an additional intrusion for surrogates who, by this point, have long fulfilled their side of the agreement.  In some arrangements this proves an impossible task and, fortunately, Mrs Justice Theis has been satisfied that the need to serve can be dispensed with if the circumstances qualify (R and S v T).

Service in UK applications is dealt with more informally.  The court issue C52 acknowledgment forms, along with the issued C51 application forms, and send these to the applicants who must then forward them to their surrogate to be completed and returned within seven days.  In practice the deadline is not strictly monitored and very often parents are not sent the correct forms, or any forms at all, following issue (with the notice of proceedings usually following at a later date in any case, depending on the court's schedule).  In this event, those who have had the benefit of legal advice may be proactive and find the acknowledgment form online so that they are then able to effect service.  Others may not be aware of the need to serve, or their surrogate may fail to complete and return the paperwork.  This is not detrimental and very often overlooked as part of the proceedings.

The treatment of service as a non-issue in UK parental order applications coupled with the reliance on the CAFCASS officer represents a stark difference from that of international arrangements.  The last two years in particular have seen the High Court family judges concerned to ensure that service on foreign surrogates has taken place and acknowledgment forms completed.  As if providing a second reassurance as to the surrogate's consent, completed service and acknowledgment operates as a vital tool to paint a picture for the judge about the surrogate, aiding the ultimate decision of whether to make the order.  If service has not been effected (as in R and S v T), parents are ordered to take the necessary steps.  Only after all reasonable efforts have been made will dispensation be considered.  Once again, one may query the diverse approach between courts over a factor of equally great importance.  One noticeable variant is the involvement CAFCASS are able to have with surrogates in the UK.  However, if this is the cause for disparity in practice, it could be argued that the role of parental order reporter should be more clearly defined across both types of application.

Conclusion
It is clear that surrogacy arrangements, wherever they take place, are risk-inherent, leading to potentially numerous issues when under the microscope of court proceedings.  What is also obvious is that there is an entirely different approach taken with international parental order applications from that with domestic parental order applications.  The former are scrutinised closely in all their detail – requiring a great deal of evidence to be filed, the latter almost rubber-stamped (subject to a positive CAFCASS report).

In Re L back in 2010 Mr Justice Hedley mulled over whether international parental order applications required a High Court process.  His conclusion was that they did, for at least the following twelve months.  We are now nearly precisely five years on from that judgment with virtually every international surrogacy application still being heard in the High Court (currently by virtue of The Family Court (Composition and Distribution of Business) Rules 2014/840).  The issues surfacing do not appear to be concerning the family judges any less five years on, though a parental order has never been refused20.

Parents who pursue domestic arrangements currently enjoy a relatively informal court process with minimal preparation necessary.  It seems fitting that where arrangements sit neatly within the criteria set out in section 54 (for example, altruistic in nature or limited to payments of only defined expenses) there is no scrutiny beyond the scope of a positive CAFCASS assessment, for the issues are contained.  However, where UK arrangements push the boundaries of the current legislation (as most overseas arrangements do), it could be argued that it is only appropriate that these are assessed with a greater degree of scrutiny than the former before a parental order can justifiably be made.

The reality is that the current law is bursting at the seams, and applications have fallen into one of two categories – the tranquil and the gruelling – with no scope for a middle ground.  The last seven years, since Re X & Y [2008] EWHC 3030 (Fam), has seen the judiciary desperately expanding the legislation, on a case by case basis as opportunities arise, so as to ensure vulnerable children are provided a legal solution.  However, there is only so far it can be stretched before its raison d'être becomes obsolete.  A new system, which reflects the reality of surrogacy arrangements in the UK and overseas, is not merely long overdue but absolutely essential to adequately protect children born through surrogacy at the earliest possible opportunity, and offer much needed assurance to the adults involved.  
http://www.familylawweek.co.uk/

Europe in Ukraine - why foreigners go to the third world country for artificial insemination?

Only a short time ago, Ukraine, state in the Eastern Europe, was unknown and sometimes even alarming for residents of European countries. Euro 2012 football championship matches that were held in Ukraine have lifted the veil a little and shown the world Ukrainian hospitality, beauty of cities and friendliness of local people. Modern reproductive medicine, in particular surrogacy and egg donation, is an additional factor attracting foreigners in Ukraine.

Infertility has been gaining momentum with each passing year, and with regard to the development of modern medicine the number of infertile women doesn’t reduce. According to the WHO statistics, every seventh couple in developed countries faces with infertility diagnosis. Surrogate motherhood and egg donation have already become the only way for such families to have own child.

Center for human reproduction BioTexCom welcomes couples from all over Europe and conduct successful programs using assisted methods of reproductive medicine. Ukrainian legislation is one of the most loyal in this field. Ukrainian law allows conduction of commercial surrogacy, egg donation, and there is no age limit for those ones who want to use IVF. Couples from around the world conduct medical programs in Ukraine and successfully come back home with legal documents, not violating nor Ukrainian law no legislation of own countries.

Every year number of patients who want to undergo IVF procedure, surrogacy or egg donation in Ukraine has been increasing. These programs are rather popular among older people, 48-68 years of age. These are families who want to have common children in the 2^d, 3d marriage.

Italian, French, German, Spain infertile couples of different age go to BioTexCom center in order to use IVF in Ukraine. In most European countries surrogacy and donation are banned. As of Ukraine, ART cost is not so expensive for foreigners; there is a good service and friendly laws.

BioTexCom Medical Center was founded in the capital of Ukraine, Kiev, for foreign patients’ special benefit. Managers and interpreters who work in BioTexCom are fluent in German, English, Italian, Spanish, Romanian, Hebrew, Chinese and Arabic. Client managers not only perfectly know foreign languages but also lived abroad. It gave them a great opportunity to explore culture, mentality and traditions of people whom they meet today in the Ukrainian clinic.

Thailand - surrogacy Mecca is closed

As a result of major scandals with participation of Thai surrogate mothers and attended parents local government has passed a new law banning surrogacy in Thailand.

Such a loyal and user-friendly Thai law was changed for criminal liability for surrogacy conduction. Now surrogate mothers and foreigners who want to carry on this procedure with financial compensation will answer for their actions in court.

Not so long ago Thailand was one of the most popular medical destination attracting thousands of childless foreigners. Low price for the surrogacy program, loyal laws concerning assisted methords of reproduction, possibility to use services of local surogate mothers for non-traditional couples and singles - all these factors actively promoted surrogacy tourism in Thailand.

In recent years Thailand shuddered world public with scandals, the main participants of which were foreign couples and Thai surrogate mothers.

The last scandal case got a great response. Australian couple abandoned their biological baby born of a surrogate mother because he had Down syndrome, leaving the baby in Thailand.

After that government has revised laws on surrogacy and now this procedure is allowed only if both spouses are citizens of Thailand, or at least the nationality of the country has one of them. In addition, under the new law surrogate mother must be Thai citizen and over 25.

Thailand is not the only place where surrogacy could be done. There are alternatives of course. For example, Ukraine also can make boast of friendly legislation that permits surrogacy and egg donation programs. The only minus is that only heterosexual couples who formalized their relationships can use   services of surrogate mother. Ukraine offers reasonable prices, good service, and high success rates of ART programs, worthy base of donors and surrogate mothers. Line of patients to start the program can become a certain drawback in Ukrainian clinics. Since Ukraine has already gained medical trust of European residents, centers of reproductive medicine have to queue up patients. After all, selection of donors, surrogate mothers and other medical processes take a certain time. 

Now, after Thailand has left the ART market Ukraine has been preparing to accept greater number of infertile patients. Chief Doctor of BioTexCom medical center notes - "We welcome a lot of infertile patients from different countries all over the world, and this number has been growing from year to year. Our clinic also does not stand still. We develop and expand in order to take a large number of patients adequately and provide them with qualitative service. Now we open additional laboratories, expanding clinic’s territory, as well as increase staff of client managers, interpreters and medical workers ". 

Should androids have the right to have children?

In contemporary science fiction, we often see robots passing themselves off as humans. According to a UiS researcher, the genre problematises what it takes to be accepted as a human being and provides a useful contribution to the debate about who should have the right to reproduce.

Science fiction culture has prospered and gone from being for nerds only in the 1970s and 1980s to becoming part of popular culture in the last two decades. This particularly applies to the TV series genre, which has become mainstream with Battlestar Galactica (2004), Heroes (2006) and Fringe (2009).

"The genre has evolved from depicting technology as a threat, to dealing with more intimate relations between humans and machines", says Ingvil Hellstrand. In her doctoral thesis, she points out that science fiction today is often about humanoid androids that are trying to become "one of us".
According to Hellstrand, this is not incidental.

"Contemporary science fiction reflects current changes in a destabilised world, relating both to boundaries between Us and Them and the boundary regarding what it means to be human. This theme is closely connected to the revolution in medical technology in which we find ourselves", Hellstrand explains.

She debated this at the University of Stavanger earlier this year with her thesis "Passing as human. Posthuman worldings at stake in contemporary science fiction".

The struggle for acceptance

In her thesis, Hellstrand refers, among other things, to the male humanoid robot, Data, in Star Trek: The Next Generation (1987) and the Cylon robots in Battlestar Galactica (2004–2009). These and the other series she has studied show changes in the science fiction genre, while also highlighting how the struggle to be accepted as human is related to the development of society.

Data is an android with advanced, artificial intelligence who is attempting to learn human behaviour. He deduces that being a parent is an important part of the human experience, and decides to reproduce and have a "daughter".

Hellstrand believes that Data is an interesting example of our own contemporary possibilities and challenges.

"Data argues for parenthood as a practice and not merely as a purely genetic identity. This feeds right into the debate that has been going on in Norway since the end of the 2000s. Norwegian biotechnology legislation was revised and opened access to assisted reproduction for all co-habiting women in either heterosexual or homosexual relationships", explains Hellstrand, who is also affiliated with The Network for Gender Research at UiS.

The right to have children

The gender researcher believes that an obvious question in the current debate is: If surrogacy is allowed in Norway, then in the name of equality, will a single man also have the right to become a single parent? Furthermore, will two fathers be acceptable?

Hellstrand points out that the discussion about reproduction is closely connected to both political rights and the right to control our own bodies, which is an important feminist argument.
"Regarding surrogacy, feminist principles relating to the mother's body and rights are also challenged by men's needs and rights to provide care for children. It is important to discuss such matters from a new perspective based on the current technological situation, without either overlooking or clinging to traditional feminist arguments", says Hellstrand.

"The question regarding who should have the right to assisted reproduction is a debate that changes with our understanding of what it means to be human and the norms relating to identity and belonging, especially parenthood. These are big questions that we, as a society, are struggling with", Hellstrand says, and refers to Nina Karin Monsen who blindly argues for a distinction between those she calls "natural children" and "constructed children", where the constructed children are a result of assisted reproduction among homosexual couples.

Unlike Monsen, Hellstrand thinks that the term "natural" should be problematised to a greater degree. She wishes to challenge our conventional conception of what is natural by referring to science fiction.
"The cyborgs are now having children. Cyborg in this context refers to Donna Haraway's political figurations for describing how technology and biology have become so entangled that it is almost impossible to distinguish them from one another. Take assisted reproduction, for example. It provides technological assistance to – or enables – biological processes. As Haraway says: "With our increasing dependence on technology, we are all cyborgs. Perhaps the androids will be next?"

The new enemy image

Hellstrand regards the science fiction genre with its radical future scenarios as suitable for shedding light on the ethical and political dilemmas of our time. The researcher also emphasises the ability of science fiction stories to absorb changes in society when it comes to the threat of terror.

The TV series Battlestar Galactica is about human survival when faced with a warring society of robots called the Cylons. They see themselves as a new step on the evolutionary ladder, with a greater capacity for feeling and giving love than humans. Their attacks and infiltration are a revolt against human hegemony, and the goal is to exterminate mankind.

"This series has been read as one that focuses on global political and ethical issues after 9/11. The series illustrates how fixed enemy images are gradually replaced by a new, more fluid and uncertain image of an enemy: The enemy is among us", Hellstrand explains.

The most significant robots in Battlestar Galactica appear in women's bodies. They have sexual and intimate relations with men. The character's love life and sex life are a central part of being accepted as human. They have a desire to reproduce in a conventional manner, precisely in order to pass as human; being human is a type of behaviour.

"They cannot be differentiated from a "real" human, and are accepted as human until they suddenly reveal that, actually, they are not. This is also part of highlighting today's uncertain enemy image", Hellstrand says.

Exploring human boundaries

Hellstrand wishes to problematise the "human" category and feels that we should be open to several possible definitions of what it means to be human.
"Identities such as mother, father and parent are often confined to a closed or restricted meaning. There are a great many implied qualities and values connected with the terms "mother" and "father". Nevertheless, we know that perceptions about current motherhood or fatherhood have changed throughout history."

Hellstrand reminds us that challenging traditional roles is a central part of feminist theory and gender research—one that seeks to broaden established gender roles rather than restrict them.

"Even though we now have new watersheds with a more open diversity of family type, it is not a given that we have a diverse understanding of motherhood or fatherhood. We need more discussion and openness here", maintains Hellstrand, who believes in a future with greater diversity in relation to identity, not least with regard to technological possibilities and social relations of our time.

Hellstrand thinks that science fiction helps shed light on what is at stake when acceptance or lack thereof challenges our perception of what a human being is—ethically, politically and ontologically. She uses feminist theory and post-colonial theory to explain how "the human" is related to our understanding of "normal" and how this in turn is linked to power relations based on gender, sexuality and race.

"Science fiction is a suitable medium for exploring humans and their boundaries. Our debate on sexuality, gender and different forms of assisted reproduction demonstrates how we understand the terms "real" or "correct". These are strongly connected to the hegemony of the heterosexual nuclear family", Hellstrand explains.

A more courageous debate is required

This year, egg donation and surrogacy are being debated under the auspices of the Norwegian Biotechnology Advisory Board.
The gender researcher reminds us that the biotechnology debate is particularly sensitive as it involves real people who have made choices, all of which are taboo, and, in some cases, not permitted by law in Norway. Nevertheless, she would like a more robust debate.

"We need a more courageous debate about what it means to be human. Science fiction can help us with this. In science fiction radical things can be started, concretised and pushed to extremes", Hellstrand says.

The researcher believes that this genre can change our perceptions and recommends that the Norwegian Biotechnology Advisory Board watch television programmes about androids.

"I think that the Norwegian Biotechnology Advisory Board must deal with future possibilities in their work on formulating ethical policy guidelines for our time. What if the advisory board had taken into account an equivalent abundance of possible social structures and social relationships as are found in the science fiction genre? I think that the Norwegian Biotechnology Advisory Board can learn from the range of dilemmas, questions and solutions that are found in fiction, and in this way perhaps consider that their suggestions should apply to future situations, and not just current ones.
http://phys.org/

Where to go for surrogacy? Countries of assisted reproductive technologies

Surrogacy has already managed to gain a foothold in the modern world. Every year number of couples who seek the help of surrogate mothers has been constantly growing. According to the statistics over the last 3 years demand for surrogacy has increased by 120%. According to the unofficial data, more than 250 thousand children were born in the world due to surrogacy. However attitude towards such method of family adding is far from certain. Most countries consider this procedure to be immoral and unacceptable, and therefore prohibit it by local law.

In such countries as France, Germany, Italy, Spain, Portugal and Bulgaria any form of surrogate motherhood is permitted.

In the United Kingdom, Ireland, Denmark and Belgium surrogacy is allowed only if surrogate mother receives no financial benefits. That is, commercial surrogacy is prohibited by the law which creates a criminal responsibility.

Nevertheless there are states which attract thousands of infertile couples from around the world to conduct surrogacy programs legally. Commercial surrogacy is legal in some states of the United States of America, India, Russia and Ukraine.

Couples who want to become parents go abroad and without violating neither any laws of own country, nor state’s where surrogacy is performed  receive desired result - so long-awaited child. Experts note - United States, India, Ukraine and Russia are among the most popular destinations for commercial surrogacy conduction. Each country has both its advantages and disadvantages in the surrogacy field. So, let's look at them in a more comprehensive way.

Going to the American clinics, you probably pay for the brand "Made in America." After all Europeans trust much more America than, for example, a little-known Ukraine or doubtful India. In the USA, surrogacy program costs about 40 - 60 thousand dollars. This price doesn’t include meet and greet services, accommodation, food and other necessary services for a foreigner. All additional services are borne by the client. Clients have to pay for each IVF attempt separately. On the other hand, in America, you get a high level of services, advanced technologies and American passport for a newborn baby that opens good opportunities for him in future. 

A lot of European citizens go to the Russian Federation in order to use surrogacy. There this issue is clearly stated in the law and absolutely legal. But there is a danger that surrogate mother will change her mind to give your baby after his birth. And the law in this case will be on the side of surrogate mother. There are also a lot of intermediary agencies in Russia, which don’t require state licensing. As a result market of surrogate motherhood includes a lot of scams that take customers money and disappear or don’t conduct any proceedings in reality. Despite these drawbacks there are still those who will find Russia appropriate country for surrogacy program. Because country's legislation mentions anything about the possibility of using such program by couples who are not registered their family relationships, single women and men, as well as non-traditional couples.

India has managed to enter the list of surrogacy leaders as well. Indian law concerning surrogacy has no particular limits: unmarried men or women, couples who registered their marriage or those who live in a civil marriage can choose surrogacy program in India. As of the price, it costs about 20 thousand dollars, which is much less than in European or American clinics. But there is another side of the coin - often, surrogacy process occurs in conditions that are far from norms and standards. Surrogate mothers don’t go through all needed medical diagnosis and tests. They live in insanitary conditions. It should be also noted that there is a non-standard Indian law concerning ultrasound diagnostic. It is forbidden in India! Therefore biological parents of the child risk of getting ill and sometimes with serious disabilities or physical defects child.

Ukraine pleasantly surprises. The third world country, weak state, debilitated economy and collapsing infrastructure. But local clinics show rather good results in the sphere of reproductive medicine. Surrogate mothers are carefully checked in accordance with the international requirements. Appropriate price, "all inclusive" programs, and even 100% guarantee - all these can be found in Ukraine. Despite this fact Ukraine is a country where majority of Europeans are afraid to go to. 

However those ones who have visited Ukraine found that it’s a beautiful, civilized country, with high rates of success in the field of assisted reproduction. This country, located in the Eastern Europe, has the most loyal legislation concerning surrogacy. It’s all because of the legality of the procedure and good prices, many Europeans go to Ukrainian clinics to take advantage of surrogate motherhood there. As a result of the massive influx of patients it can be seen a shortage of surrogate mothers. In addition, turn to join the program sometimes can last for 1year.Those patients who have already conducted the program share their happiness and pleasant experience http://mother-surrogate.info/uk-couple-tell-success-surrogacy-story/

Surrogacy families adjust to new lives

VINCENNES, Ind. - Neither Sara McCarter nor Tara Pearce ever worried about what would happen once Tara gave birth to Sara’s twins — it was the rest of the world that wondered.

“Everyone kept asking me if I would be attached to them,” said Tara, who carried Sara’s biological twins as a surrogate. “They asked me if it would be hard to give them back. They weren’t my babies to begin with.”

In fact, Tara said just minutes after giving birth on Easter Sunday that it felt like she was visiting a good friend who’d given birth, not that she’d carried those babies for nine long months.

“It was amazing,” she said of the speedy birth. “We talked throughout the night about how it was awesome for everyone; it couldn’t have gone better. It went so fast that there was no time to be nervous or expect anything. It was perfect. I think emotionally it helped me a lot to have such a good delivery. I didn’t feel sad afterward.”

Mila, weighing 6 pounds, 2 ounces, was born at 7:11 p.m. April 5. Her twin brother Blaine weighed 6 pounds, 1 ounce and was born 15 minutes later.

Although the women are the best of friends now, Sara and Tara hadn’t even met a little more than a year ago. Sara was working with Surrogacy Together — an organization whose mission is to raise awareness of the surrogacy process — to find a surrogate.

The group doesn’t pay for the process but instead works with professionals — reproductive lawyers, surrogacy agencies, reproductive specialists, etc. — who offer their services pro bono or at a significantly reduced cost making the financial burden one that the McCarters, both 29, felt they could bear. A typical surrogacy costs between $60,000 and $120,000.

Sara was talking about her search for a surrogate at work when co-worker Chris Pearce, Tara’s husband, overheard. The Pearces had talked about the possibility of surrogacy so Chris approached Tara with the idea.

Soon the families met, a contract was signed and the deal done. Tara agreed to be the surrogate with no financial compensation — typically a standard part of a surrogacy arrangement. She’d been blessed with being mom to five children of her own and wanted to help McCarter experience that same feeling and couldn’t imagine taking money, Pearce said.

‘It’s time’

“When my phone rang I just knew it,” Sara said, still struggling to suppress her giddiness months after the phone call. “But I guess every time my phone rang I thought that. I picked it up, and Tara was so excited I couldn’t make out what she was saying, but I knew. I started screaming back. We were talking in jibberish together.”

Sara nearly jumped over her husband to get out of the restaurant booth and head to the hospital.

Sara and husband Zach, of Wheatland, were waiting outside the hospital with their hospital bags and baby supplies ready to go.

But Tara wasn’t in much of a hurry. She’d had a hankering for Taco Bell, and even with her water broken and contractions starting she was vacuuming her bedroom. Tara also still had her sights set on hitting up the fast food restaurant before going to the hospital.

She even asked her husband Chris if he thought she’d have the babies that night or the next day. As he was trying to rush her along he answered, “Definitely tonight.”

Tara checked into Vincennes’ Good Samaritan Hospital at 7 p.m.

“As I was getting changed and they were all in the hallway I knew,” Tara said. “It’s time!”

Sara thought there were still hours left before she’d become a mom. As a surgical nurse at the hospital, she was visiting in the hallway with staff she knew well.

“I heard her scream, ‘Get in here now!’” Sara said. “I ran in and asked what was wrong. She was ready to push.”

Before an obstetrician could even arrive, Mila “just popped out on the bed.” The anesthesiologist delivered his first baby that night, just 11 minutes after Tara checked into the hospital.

“I remember instantly crying,” Sara said of the moment. “I was so excited and happy to see her but so terrified because we didn’t have an OB. I left Tara’s side and ran over to the warmer. I kept asking the nurses, ‘Can I touch her?’ I was sobbing. It was the most amazing feeling — instant love. I’d dreamed for this day. I can’t even express what it felt like. I’d never experienced so much excitement and pure insanity in one moment.”

The on-call OB arrived and prepared to deliver Blaine. The care they received, even in the midst of such a speedy delivery, was impeccable, the women said.

In all of the chaos, Sara was finally handed her daughter, who she slipped inside her shirt so the two could bond via skin-to-skin contact.

“I was so happy but still at this point scared for my son who was breach,” Sara said. “Watching him be born was so scary but amazing to see. I’d be looking and then have to turn away but would have to look back. Once he was born it was instant relief.”

Blaine was checked over, and then given to Zach for skin-to-skin contact.

“I knew Tara was OK because she instantly said, ‘When do I get to go home. I need to go to the bathroom,’” Sara joked. “I knew then we could focus on the babies.”

‘It was so natural’

Sara and Zach stayed in the delivery room with Tara and Chris for quite some time switching babies. And then Sara held both of them at the same time.

“They were hungry so I nursed them,” Sara said matter-of-factly, “both of them at the same time. They latched right on. It came so naturally. They instantly knew what to do.”

She’d spent months leading up to their birth preparing her body to lactate, having to take special medications combined with the use of a breast pump. This was something Sara wanted to do. She felt robbed being unable to carry her own children. But this was something she could provide them.

“I was so scared my motherly instincts wouldn’t kick in because I didn’t experience pregnancy,” she said. “But it was so natural. I started crying instantly saying, ‘Oh my God, I can’t believe I’m doing this.’”

From time to time the nurses came to get the babies from Sara to take them to the nursery for needed procedures, and while Sara knew it was routine and necessary, she could barely let them out of her sight.

“I just sobbed if they took them,” she said. “I waited so long for these babies and love them so much. Even when Tara was pregnant, I know I couldn’t bond with them the same way if I was carrying them because they were in her stomach. But I still grew to love them like anyone would who was pregnant. I was attached to them. If I went several days in a row without seeing Tara, I truly missed them; I’d have separation anxiety not being by them. So now, I finally had them, and I didn’t want to let go of them.”

The relationship that had grown so strong over the last year didn’t just stop after the babies were born. Both women said they’ve found a new friend for life.

“I love her so much, and she loves me,” Sara said of Tara. “She has become one of my best friends through this experience. I couldn’t stop talking to her all the time.”

Tara said the two will always remain close friends and the twins will always be a part of her life, although her relationship with them will be no different from that of the children of her other close friends.

“It’s odd,” Tara said. “You’d think it would be different with them, but it’s not. I’ll always like to love and snuggle on them, but it’s not different. During this whole process I never was afraid of what would happen after the delivery. I knew I wouldn’t be attached to the babies.”

Tara didn’t even hold the babies until the next day, the day she was discharged from the hospital.

“We didn’t know what to expect with this experience,” she said, pointing out she would do this again with the McCarters in a heartbeat. “It was a great experience. I have always had a special place in my heart for women struggling with fertility. I feel guilty that Sara couldn’t experience this for herself. So anything I could do to help that, I was glad to do.”

Changing priorities

Life for the McCarters is drastically different.

“Our whole life revolves around them and their schedule,” Sara said. “Priorities, everything totally changes. It isn’t about us anymore; it is always about them.”

But with those changes come an infinite amount of love and fulfillment, she said.

“The amount of love and satisfaction with my life, now that I have it my heart finally feels full,” Sara said. “I finally feel truly happy. I expected all of that. What I didn’t expect were the challenges with multiples.

“When you live it, woo! It is worth every second, but it is harder then I ever thought it would be.”

It took Sara and Zach a few months to get the hang of things but Sara said they have life down pretty well.

“It really is the best,” she said. “My life, it has changed completely. I go to bed at 8:30 p.m. Before the babies that would never have happened. Zach and I may have gone out on the deck and drank some beers on a Saturday night until midnight or 1. Now my Saturday night consists of trying to help my son to roll over and going to bed by 8:30. But I’m so happy with that. It’s a great change.”

Her gratefulness to Tara and the entire surrogacy experience hasn’t worn off yet.

“We are so lucky, we have so many people who have been so supportive throughout this process,” Sara said.

From an egg retrieval party and surprise shower from work friends to gifts and showers from families, she said the support has been strong.

Next steps

Life suddenly has meaning for Sara.

“It feels so good to have purpose,” she said. “Before I felt like I had no purpose in life. I would ask, ‘What am I here for? What am I doing?’ Now I have these amazing two babies. I wake up every morning because of them, because they need me. I love that feeling. It’s amazing. I wouldn’t trade it for anything.

“I can’t picture my life without them. I think back to life before babies and say, ‘What a crappy life. It sucks. I can’t believe I did that for so long.”

In the throes of raising two infants, Sara and Zach are focusing on the children they have and giving them the best possible life.

“As far as a sibling, we’re just not sure,” she said. “We’re not opposed to it but we’ll just see what the future holds. ... Either way, our lives are complete with Blaine and Mila.”

Tara isn’t ready to become a “professional” surrogate anytime soon but said she would carry another child for Sara and Zach in a heartbeat.

But for now, Tara — who has five children of her own ranging in age from 2 to 13 — is looking forward to the next step in her journey, nursing school. She is a registered X-ray technician so the medical field isn’t completely foreign to her.

“I love helping people,” she said. “This is another way I can do that. And now that the kids are getting older and I’m done with surrogacy for now, it just seems like a good time.”

Her goal, once she becomes a registered nurse, is to work in OB.

‘Don’t give up’

The idea of surrogacy can seem like an unobtainable and overwhelming process, Sara said. But for those couples struggling with infertility it can be a feasible option, she said.

“I wanted this so badly,” Sara said. “So I found a way to make it happen. You could too, that is the amazing thing about surrogacy. It is a second chance to have a family, even if your body is broken, and you are incapable of doing it. There is still a way to get your baby home.”

For Sara, even before Tara was pregnant, she loved the babies so much. She loved the idea of them. When she learned surrogacy was a possibility, Sara couldn’t shake the idea.

“When I knew I could do this, how could I not do it?” she said. “You do what you have to do. We gave up a lot, made a lot of sacrifices, so we would have the funds to do it. I researched grants and programs. And that’s how I discovered Surrogacy Together.”

But once the surrogacy is underway, the challenges haven’t subsided, the roller coaster journey is just beginning.

“I know it can be so hard,” Sara said. “It is a constant waiting game. There are so many emotions up and down. And someone else having your baby is so hard. But you have to stay focused on the end results — at the end of day you’re going to have your family. No matter how hard it is, it’s worth it.”
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