The definition of “Family” it is as diverse as it is personal, frequently defined by our preconceptions, but more than ever being redefined by the human diversity of relationships in an ever changing modern world.
The concept of parenthood has broaden, and become inclusive of previous nontraditional formats. All couples and singles, gay or straight men and women desire becoming parents. However, many are the difficulties in achieving it, imposed by previous traditionalistic bias, and technologic barriers. These obstacles have historically denied for long single man and women, same sex couples, and women that would like to delay their fertility, or cannot carry a pregnancy, of pursuing their dreams of a Family.
There have been many advances in reproductive medicine for the past five decades that have radically change the way we currently look at family building. We are now able to store eggs and sperm, create embryo storage banks that can be accessed at a later date, and permit fertility opportunities. The development of assisted reproductive techniques (ART) describes the use medical technology in the assistance to achieve a pregnancy. These techniques encompasses egg and sperm donation, intrauterine insemination (IUI), in vitro fertilization, gestational surrogacy, and other types of fertility (or infertility) treatments (see below).
The development of highly specialized fertility techniques have permit us to develop safer and more successful embryo creation, testing, and storage. Individuals with many genetic diseases have the ability of testing their embryos before an embryo is transferred (preimplantation diagnosis). However, advances in science have not always been in pair with both national and internationally sociologic development and law. This has created an unequal differential in opportunities around the world where this techniques are available. More, over the cost involved is often a major impediment in the pursue of couple in their wishes for parenthood.
Since there is not only one, or a more acceptable way to build a family, it is important to understand the individual pros & cons, and the various degrees of complexity of the each option. Briefly, here are some of the current major choices for nontraditional parenting:
- ADOPTION/FOSTERING: Adoption and fostering having available for a long time, all across the world, and have permitted for children to have a family where there was none. In adoption a new family will assume care of the child, while in fostering will be only temporary solution. There is often a long and laborious process of screen the potential new family that does or should not discriminated against of race, religion, or sexual orientation. It is often a very heavy bureaucratic process that is varies immensely in their time-line from months to years.
- CO-PARENTING: Co-parenting results from an agreement between two parents that work together to raise a child even though they are not living together, or do not wish to be in a conventional relationship. These arrangements are seen common among gay and lesbian parents that team up to parent the child together. This can be a complicated process needing frequently of legal guidance.
- THIRD PARTY REPRODUCTION is defined by the donation by “third” person, called a donor (i.e. eggs, sperm, or embryos) that will permit parenthood to whom otherwise would not be able to. The process can be done with an anonymously or a known donor.
EGG DONATION: Egg donation is available to women that cannot use their eggs (i.e. due to severe decrease in their ovarian reserve, poor quality eggs, have undergone ovarian failure, have no ovaries, or have a severe genetic disease that they wish not to pass to their offspring), single male and gay couples that desire to be intendent parents. The egg donation can be known or anonymous. Donors will undergo controlled ovarian hyperstimulation, followed by the egg collection in a fertility clinic. The eggs will then be fertilized with sperm (see below for options). The costs are related to the screening, drugs used to stimulate the eggs, and a variable donor stipend. There are many resources on finding donors that vary from a privately known, to clinic-base and agency-base programs. There are programs that offer frozen eggs that have been stored, and/or “fresh donors” that will be able to cycle and create embryos from the collected eggs. There are multitude of important factors when choosing a donor, such the intendent parent personal preference for a particular personality and appearance trait, the donor fertility status, and her previous fertility outcomes. Your reproductive endocrinologist will be able to aid and validate your donor choices.
SPERM DONATION: Sperm donation has been around since the 1940s, where the sperm is obtained from a source unrelated non-partner (known or anonymous types). The sperm may be used for insemination through a fertility clinic, or less frequently used in a home setting with a home insemination kit. The resulting embryos created through in vitro fertilization at a clinic can be stored, or used to be transferred into the recipient’s receptive uterus. The donor sperm can be obtained also from a commercial storage banks. Here the available donors have been medical screened, and the frozen samples stored that are readily available for a fee. The use of donor sperm is often indicated in cases where there a severe male sperm problem, and also for single straight or lesbian women desiring fertility.
EMBRYO DONATION: Embryo donation permits that embryos that have been created through assisted reproduction to be donated by the parents to other/s to achieve a pregnancy. This embryos have been generally frozen and stored. The process is similar in many ways to an adoption, although with a short waiting period. The preparation of the uterus to become receptive to implantation will be the most important step in the process. The intendent parents won’t be genetically related to this children, and there are only a few embryo donation programs available.
SURROGACY: Surrogacy is defined by a pregnancy that is carried for someone that otherwise would not be able to have fertility. There are two types of surrogates, a traditional (where the surrogates uses her own eggs, and is genetically related to the child), and non-traditional, also called gestational (using of an egg donor, and is not genetically related to the child), using a sperm source from either the intendent parent, or from a donor. Surrogacy is an important option for, women that can’t carry a pregnancy (i.e. do not have a uterus, or have a contraindication for pregnancy), for single straight and gay men, and gay couples wishing to become parents. In surrogacy there are many parties involved, from the intendent parents, the egg donor, the surrogate that need to come together clinically, and conform legally. Legal contracts between the carrier and intendent parents need to be concluded prior to the start. Legal aid is often necessary to help intendent parents in navigating through the national state, federal and international laws. The process is costly, and often with a time-line that can extend for more than one year from start to delivery. There are not many countries permitting surrogacy to be done, with even fewer that are maintain high standards and safe guards, and skilled dedicated clinical centers.
EGG PRESERVATION: It is also worth mentioning here egg preservation, since many women will want for various reasons to preserve their fertility. In egg preservation women will undergo an ovarian stimulation cycle much similar to in vitro fertilization, with the intent of freezing their eggs. Some women will combine the egg freezing with the embryo creation and freezing at this stage for later usage. Single and couples, gay or straight can take advantage of the reproductive tool for wanting to delay their fertility. Another common use is for women that are anticipated to undergo cancer therapy with medication that are known to affect the future reproductive function of the ovaries. The results vary depending on the woman’s age, and fertility assessment status.
The acceptance of alternate parenting is increasing worldwide, although there are still many culture barriers that will permit to embrace underrepresented groups such single women and man, and gay or lesbian parents in building non-traditional families. There a few countries that permit the use of assisted reproduction safely for these intendent parents, and many are the legal and financial obstacles that they have to go through. There is a large body of scientific evidence that has been studying the outcomes for children being built in these families reporting that they are as well-adjusted, well-rounded as in “traditional parenting”, with no apparent impact on the self-esteem and overall well-being.
It seems that medical technology in assisting the reproduction, and third-party reproduction in alternate parenting may be ahead of the lagging cultural and legal restrains. It is important for intendent parents to have experience guidance both in the reproductive and legal landscape before the start their journey to parenthood. The most important reflection for intendent parents is to advise to take time and be well informed when making decisions about the steps that will lead to your decision-making process in building your family through a non-traditional path.
The outstanding advances in the field of reproductive medicine are now empowering many previously underrepresented groups with the tools to freely pursue their path to parenthood without prejudice.
For, ethical, compassionate, and knowledgeable care to the building of your family, please contact our office today for additional information, and schedule a free of charge third party consultation with us.