Family Creation for LGBT Military Couplesmilitarypartners.org/wp-content/uploads/2009/12/AMPA-Webinar-Fa… · 36 Los Angeles headquarters is a 42,000 ft2 facility Branches: Westwood,

Family Creation for

LGBT Military Couples

Facilitator:

Dr. Lori Hensic

Director of Educational Affairs

The American Military Partner Association

[email protected]

© 2014, The American Military Partner Association

Disclaimer

Please note that the information presented here is

not all encompassing or an exhaustive list of

options available. It is for informational purposes

only and should not be construed as medical

and/or legal advice. Please contact your medical

provider, medical insurance, lawyer, and/or the

organization with which you intend to pursue

family creation for more information on how

these options apply to you specifically.


Content

Outline

Voluntary Infant Adoption Ann Wrixton

Independent Adoption Center

Adoption from Foster Care Rich Valenza

RaiseAChild.US

Surrogacy & Egg Donation Erica Bowers

Growing Generations

Sperm Donation, IUI & IVF Carla Pedrussian

California Cryobank


Voluntary Infant

Adoption


LGBT Military Families & Voluntary Infant Adoption

Presenter:

Ann Wrixon, MSW, MBA Executive Director, Independent Adoption Center

[email protected]

1.800.877.OPEN (6736) adoptionhelp.org

iheartadoption.org

• Founded in 1982 to facilitate open infant adoption

• Counseling-based agency

• Has never had any discriminatory policies

• Has been doing LGBT adoptions for 31 years


2013: 188 Placements

30% (56/188) with LGBT families

Licensed in:

• California • Texas • New York • Florida

•Indiana • North Carolina • Georgia •Connecticut


Sexual Orientation of Adopting Couples

81 196

277

921

1,475

0

200

400

600

800

1,000

1,200

1,400

1,600

Lesbian Couples

Gay Male Couples

Total Gay/Lesbian

Heterosexual Couples

Total Adoptions

Number of Adoptions from 1/1/2006 – 3/28/2014

Open Adoption is the Norm

• Significant research shows open adoption has the

best outcomes for:

– Adoptees

– Birthparents

– Adoptive parents

• See: http://www.adoptionhelp.org/open-adoption/research

The following statements are MYTHS

LGBT Families Do NOT have Longer Waits:

“LGBT families have a

longer waiting period

than heterosexual

families.”

“The longer wait is

due to birthparent

bias.”

Average Wait time to Placement: 15 Months

Agency Policy Matters

• Agencies should:

– NOT ask potential birthparents if they are open to LGBT or

“non-traditional” families

– Integrate LGBT families into all marketing materials

– Integrate LGBT cultural competency into all staff training

– Earn Human Rights Campaign Seal for Best Practices

Special Consideration for

Military Families

• A new duty station in a new state requires a new home

study

• Many domestic adoption agencies cannot make

placements out of country

• If one partner is deployed they will need to come back

for the birth of the child

Costs of Agency Adoption • $15,000 – $30,000

• Adoption Tax Credit is $13,190/child in 2014

– See: http://www.adoptionhelp.org/adoption-tax-credit

• Military Family Reimbursement: $2,000/child

– See: http://www.militaryfamily.org/your-benefits/adoption/reimbursement/

• Other Grants and Loans

– See: http://www.adoptionhelp.org/financial-aid

Contact Us

Ann Wrixon, MSW, MBA Executive Director, Independent Adoption Center

[email protected]

Adoption from

Foster Care


Building families

in the LGBT community to

solve our nation’s foster care crisis.

Presenter:

Rich Valenza Founder & CEO

RaiseAChild.US

[email protected]

RaiseAChild.US believes that all children deserve

a safe, loving, and permanent home.

We educate and encourage the LGBT community to build

families through fostering and adopting to answer the needs

of the 400,000 children in our nation’s foster care system.

>12,000 • Each month the Los Angeles County Department of Children &

Family Services receives 12,000 to 15,000 calls to its hotline.

7% • As a result, about 7% of those children come into protective

services through no fault of their own.

>30 • Each day about 30 children enter the foster care system in

Los Angeles County alone.

• 400,000 children of all ages in U.S.

foster care

In most states…

• The no cost option of family building

• Monthly financial support

• Health and dental insurance

coverage

• Supportive resources

• Higher education incentives

Why Foster?

• 104,000 children in U.S. foster system

waiting for adoptive homes

In most states…

• The no cost option of family building

• Monthly financial support

• Health and dental insurance coverage

• Numerous supportive resources

• Most children come with files of

medical and education history

Why Fost/Adopt?

• A free service

• A supportive service working to help

you reach your goal of building or

expanding your family

• Non-discrimination policy, offering

services to all singles and couples,

regardless of sexual orientation

• A national network of LGBT culturally

competent fost/adopt agencies

• Success rate 6 times greater than

national average

Why RaiseAChild.US?

• Personalized support

• Phone, email and social media

• Outreach campaigns

• Educational events

• Help selecting an agency

• Assistance moving through process: • Orientation

• Training

• Certification

• Placement

• Finalization

Our Free Service

Take the Next Step to Parenthood

Surrogacy &

Egg Donation


FAMILY CREATION THROUGH

SURROGACY AND EGG DONATION PRESENTER:

ERICA BOWERS PRESIDENT, GROWING GENERATIONS [email protected]

COPYRIGHT 2014, GROWING GENERATIONS, LLC

WHAT IS FAMILY BUILDING THROUGH

SURROGACY AND EGG DONATION

Surrogacy/Egg Donation is a collaboration, a coming together

of many people to help someone become a parent.

The Surrogate, Intended Parents, Sperm or Egg Donor, Doctor,

Lawyer, Agency, Psychologist, as well as family and other

support people are all part of a team with one goal in mind--

helping someone become a parent.


HOW IS PREGNANCY ACHIEVED

There are two types of surrogacy:

Traditional Surrogacy

Surrogate impregnated with sperm (either from male parent or sperm

donor)

Surrogate genetically related to the child

Gestational Surrogacy

With an egg donor

Via IVF and embryo transfer

Surrogate not genetically related to the child


SURROGATES: WHO ARE THEY?

Surrogates are women who:

have had their own children and love being pregnant

have a strong support network

are physically and emotionally healthy

are fully screened medically, psychologically and legally

are financially secure

are good communicators

have no history of drug or alcohol abuse, are non-smokers and have no criminal past

want to help someone become a parent by giving the ultimate gift: life


SURROGATES-WHY DO THEY DO IT?

Surrogates are motivated by a healthy mix of narcissism and altruism

They know that not everyone can give this gift and that they can

They are philanthropic by nature and feel that this is the ultimate gift

They feel honored to help someone know the joy of parenthood

They treasure the moment they see the new parents holding their baby for

the first time

They welcome a relationship with the parents now and in the future


EGG DONORS-WHO ARE THEY?

Egg Donors are women who:

are between the ages of 21-30

are physically and emotionally healthy

are fully screened medically, psychologically, legally and genetically

have no family history of high risk genetic disorders

have no history or drug or alcohol abuse, are non-smokers

do not feel an attachment to their eggs, as their children

are willing to remain anonymous or are willing to meet the parents and the offspring

want to help someone become a parent by giving the ultimate gift: life.


WHAT IS THE COST?

The average surrogacy with an egg donor ranges from

$150,000-$210,000.

This cost includes all compensation/expenses for your surrogate, egg

donor, physician, insurance policies, attorney, psychologist, and agency

Unfortunately insurance (include Tri-Care) does not cover these types

of expenses

Once your baby/babies are born their medical care will be covered by

your insurance


CONCLUSION

For people who want to be parents having children is one of the great joys of life

For anyone who needs help, third party assisted reproduction is a wonderful

collaborative way to fulfill the path to parenthood

Ensuring that parents, the surrogate and donor are fully informed, well screened,

educated about and supported through the journey helps to ensure success and a

treasured experience for all


Erica Bowers President

Growing Generations

[email protected]

Sperm Donation,

IUI & IVF


34

Donor Sperm / Fertility Preservation

Presenter:

Carla Pedrussian Director of Marketing, California Cryobank [email protected]

35

I. California Cryobank History

II. Donor Screening & Selection

Recruitment

Screening Process

Video

Different Donor Types

Vial Types

Donor Information

I. Managing Donor Offspring

Limits

II. Fertility Preservation

Overview

36

Los Angeles headquarters is a 42,000 ft2 facility

Branches: Westwood, Los Altos, Boston, New York

Donor Semen: Distribution to all 50 states and

internationally to 75 countries

Fertility Preservation: Semen, Egg, Embryo Storage

Dr. Rothman recommends: Men undergoing

orchiectomies for cancer, transgender procedures,

or trauma be offered testicular tissue storage for

fertility preservation. (requires proper media and

access to a cryogenic facility)

Andrology Services

Complete accreditation and licensing

(FDA, CLIA, AABB, AATB, NY/CA/MA/MD STATE)

Company History

Founded in 1977 by Dr. Cappy Rothman and Dr. Charles Sims

PIONEER IN REPRODUCTIVE TISSUE BANKING

37



Recruitment

Screening Process

Video


Vial Types

Donor Information

III. Managing Donor Offspring Limits

Overview

38

The majority of national sperm banks require donors to be:

In good health

Students and young professionals

― CCB recruits from some of the nation’s top

universities including: Harvard, MIT, Stanford,

Columbia, and UCLA

― Non-student donors come from many professions

including: physicians, lawyers, sommeliers,

musicians, and physicists

Screened for high count, good motility, and normal

morphology

CCB accepts less than 1% of applicants (approx. 9/1,000)

CCB receives approx. 17,000 applications per year

Donor Recruitment

39

Donor Screening Video

• Online videos have become a preferred method to gather information on the internet • Many sperm banks now offer videos • Patients are more comfortable if the actual donor selection process is familiar to them • Over 97% of all CCB clients visit our website before making a donor purchase

Helping patients make a difficult decision easier…

40


Donor agrees to one

contact with offspring

Contact is anonymous and mediated through the bank

The child must be at least 18

OPEN

No commitment to any

contact with offspring

CCB will contact anonymous donors at the request of any offspring who are 18 or older

CCB Anonymous Donors have been receptive to contact requests

ANONYMOUS

Patients have four basic options in choosing a sperm donor:

Donor’s personal info

is eventually released

Limited selection

Timing and who may request information varies by sperm bank

ID RELEASE

Donor is non-intimate, but personally known to the recipient such as family member, friend, or colleague

Screening process for STDs same as anonymous (quarantine period may be reduced with physician authorization)

Additional genetic testing available

KNOWN/DIRECTED DONOR

41

Vial Types

There are two main vial types offered by most sperm banks: IUI (Intrauterine Insemination) vials and ICI (Intracervical Insemination) vials

IUI or “washed” sperm are processed through a

density gradient media to remove non-motile cells.

IUI vials are intended to inseminated into the uterus.

ICI or “un-washed” sperm are cryopreserved without

a wash and intended to be inseminated at the cervix.

Some sperm banks also offer low-volume specimens

meant for IVF procedures at a reduced fee

42

Donor Information Products

Sperm banks offer comprehensive catalogs of donors with a wide range of physical characteristics, personalities, talents, and interests. Most banks offer basic free information as well as more in-depth information for a fee.

The more comprehensive information is intended for those interested in getting to know the donor beyond his physical characteristics and ethnic background (single women and lesbian couples in particular).

Donor Personal Essays

Staff Impressions

Donor Profiles

Medical Histories

Extended Profiles

Childhood Photo(s)

Donor Conversations

Express Yourself

Keirsey Temperament Reports

Keirsey Q&A

Facial Features Reports

Donor Matching Consultations

Genetic Consultations

43



Recruitment

Screening Process

Video


Vial Types

Donor Information

III. Managing Donor Offspring Limits

Overview

44

Offspring Limits

Each bank is responsible for establishing and

enforcing its own policy

9/10/11 - The Reproductive Counsel of the AATB

recommends: “The Reproductive Tissue Bank shall

establish a written policy and procedure in order to

control and limit the number of offspring by a

gamete donor. This shall include the upper limits

deemed acceptable to the bank and shall describe

the methods that will be used in order to comply

with the approved policy and procedure.”

CCB’s maximum goal is 25-30 family units

Reps trained to solicit OIRs

Cryobank.com designed to make it easy to submit OIRs

Recipients emailed after a three month absence of activity

Number of specimens obtained/distributed limited

MANAGING OFFSPRING LIMITS MY ACCOUNT DASHBOARD

45

Men who are facing the following circumstances may elect to bank sperm:

- Prior to cancer treatment (chemotherapy, radiation, surgery)

- Prior to a vasectomy

- Prior to military deployment or High risk jobs (EMT, Firefight, Police Office)

- Prior to hormone replacement therapy – (gender reassignment)

- Prior to surgery, other medications which may effect fertility (such as testosterone)

Fertility Preservation Options for Men

46

Best advice: *Prevent infertility*

Radiation Therapy

- Dose related suppression of spermatogenesis

- Protect testis or reduce total dose

Chemotherapy

- Alkylating agents do the most damage

- Risk is increased with:

A. Two or more alkylating agents,

B. Higher doses

C. Combination of chemo with radiation

D. High dose cisplatinum or bleomycin may also damage spermatogenesis

Surgeries

- Testicular cancer

- Prostate or bladder cancer. Retrograde ejaculation

Cancer and Male Fertility Risks

47

Sperm Banking Process

Process:

• Once the sperm has been frozen and stored in liquid nitrogen, there is no known upper limits on how long it can be preserved. There is a case report of a live birth after 32 years of storage.

• If the patient is too sick or hospitalized and can not come to the sperm bank, a specimen can be collected off site and delivered to the bank for processing.

• The time between collection and processing should not exceed about 2 hours if at all possible.

Costs:

- Approximately $1,000 for semen freeze, RCD testing & 1 year storage. Annual storage fee $475/year

- Financial assistance available via LiveSTRONG which reduces rates by approximately 60% for those who qualify

Patient contacts sperm bank to schedule an appointment: Generally, appointments can be made same day or next day for emergencies M-F

Appointment at Sperm Bank: • Account established • Semen specimen

collected, analyzed and frozen

• Blood and urine samples collected

Semen specimen results provided to patients: Patient may provide additional specimens

48

Normal:

Normal sperm function and count. Many men undergo cancer treatment with no apparent change in their fertility.

Temporary Infertility:

No sperm in the ejaculate. Sperm production may stop for a temporary amount of time. It may return in several months or many years after treatment

Low Fertility:

Low sperm count and/or motility. This can occur due to impaired spermatogenesis, hormone production, or anatomic damage to the reproductive tract. This frequently requires IVF, etc.

Permanent Infertility:

Azospermia. Rarely, testicular sperm may be present in low numbers and could possibly extracted for ICSI.

Male Fertility After Cancer Treatment

49

Fertilization options with frozen sperm:

ICI or IUI:

– This option is for men with semen quality that is closer to normal.

IVF :

– The best option for men with a limited number of vials or poor quality.

IVF-ICSI:

– When there are very few sperm and the quality is low this may be the only option for fertility. One, two or occasionally, three embryos can be placed into the uterus of the female partner in the hopes that they will implant for a pregnancy.

Cost:

– IVF, with or without ICSI, is relatively expensive but the procedure is also very successful, especially if the woman has normal fertility and is in her mid thirties or younger

Options After Sperm Banking

Thank you!

The American Military Partner Association www.MilitaryPartners.org


For information on future webinars, contact:

Dr. Lori Hensic

Director of Educational Affairs

The American Military Partner Association

[email protected]

Documents

Family Creation for LGBT Military Couplesmilitarypartners.org/wp-content/uploads/2009/12/AMPA-Webinar-Fa… · 36 Los Angeles headquarters is a 42,000 ft2 facility Branches: Westwood,