Families Thru Surrogacy

Families Thru Surrogacy are again heading out across Australia with an excellent Australian Seminar Series for 2017

1st - 8th Feb 2017 6.30 - 9.00pm

Brisbane, Perth, Melbourne, Sydney

http://www.familiesthrusurrogacy.com/event/australiannz-roadshow/

Look up the website for details.

Interesting read: Labour of Love

Article by Lezly Herbert

July 2016  - http://www.outinperth.com/interesting-read-labour-love/

Labour of Love

by Shannon Garner

Simon & Schuster Australia

At the age of 33, Shannon Garner was happily married and living on the north coast of New South Wales, 6 hours from Sydney. She had natural water births for her two children – Jaxon (4) and Kiera (2) and she decided to become a gestational surrogate to “help someone else realise a dream they might not otherwise have the chance to fulfil.”

Sydney couple Jon and Justin had been together for 8 years they had a friend who heard of Shannon’s desire to be a surrogate. They also had a friend who was willing to donate her eggs and the four of them embarked on a year that would change their lives and the lives of everyone they cared for forever.

Shannon writes an extremely detailed account of the journey of that year, from the initial discussions to a happy reunion 7 weeks after baby Elsie is born.

She obviously has a strong spiritual connection and utilised acupuncture to help with the success of the IVF and yoga during her pregnancy. She also communicated to “her passenger” all the time and encouraged her to do the right thing so she could have a natural birth.

Her incredibly positive outlook didn’t prevent difficulties from occurring along the way and she shares her doubts and insecurities with great honesty.

It was a time when Thailand’s Baby Gammy was all over the media and there were considerable discussions about the ethics and difficulties of surrogacy. Under Australian law, a surrogate mother cannot accept payment but they can change their mind and keep the baby, even if it comes from a donor egg. Current laws vary from state to state and record numbers of childless Australian couples currently go overseas to pay a surrogate.

Calling her experience a “collective love”, Shannon had the support of a whole network of people and she has several friends who are pregnant at the same time, including some who are also surrogate mothers.

Shannon considers that she is just an ordinary person who undertook and extraordinary journey. Shannon had the absolute support of her family and they need to be admired for their altruistic belief that along with Shannon, they were “compensated by love and the knowledge that they’ve changed a couple’s lives for the better.”

what are they talking about?

I am discovering that there is a whole new language relating to surrogacy on the internet. Just like any profession, regular used terms are reduced to make communication more efficient.  People seem to have an obsession with easy to use acronyms. For those that know what is going on it is great. For the rest of us it can be a bit confronting, but interesting to learn this new “language”.

The one I like  Frostie = Frozen Embryo

A Ridiculously Long List of Infertility Acronyms

A-E

2WW = 2-Week Wait (from insemination to menstruation/pregnancy)

4WW = 4-Week Wait (from one insemination to the next insemination)

47XXY = Klinefelter’s Syndrome

ACA = Anti-cardiolipin Antibodies

ACTH = Adrenal Corticotropic Hormone

AF = Aunt Flo (menstruation)

AH, AZH = Assisted Hatching

AHI = At-home Insemination

AI = Artificial Insemination

AI+ = Artificial Insemination with some “assistance” from the recipient (not common)

AIH = Artificial Insemination from Husband

ANA = Anti-nuclear Antibodies

AO = Anovulation

AOA, AVA = Anti-ovarian Antibody

APA = Anti-phospholipid Antibodies

APTT = Activated Partial Thromboplastin Time

ART = Assisted Reproductive Technology

ASA = Anti-sperm Antibody

ASRM = American Society of Reproductive Medicine

ATA = Anti-thyroid Antibody

AWOL = A Woman On Lupron

B2 = Baby Two (mailing list)

BA = Baby Aspirin

BBT = Basal Body Temperature

BCP = Birth Control Pills

BD = Baby Dance (sex)

BFN = Big Fat Negative (pregnancy test result)

BFP = Big Fat Positive (pregnancy test result)

BG = Blood Glucose

BMS = Baby-making Sex

BSE = Breast Self-Exam

BT = Balanced Translocation

BW, b/w = Bloodwork

C# = Cycle Number

CAD = Carbohydrate Addict’s Diet

CAH = Congenital Adrenal Hyperplasia

CASA = Computer-assisted Semen Analysis

CB = Cycle Buddy CBAVD = Congenital Bilateral Absence of the Vas Deferens

CCCT, CCT = Clomiphene Citrate Challenge Test (Clomid Challenge Test)

CD = Cycle Day

CD56+ = Natural Killer Cells

CF = Cervical Fluid

CM = Cervical Mucus

CMV = Cytomegalovirus

CNM = Certified Nurse Midwife

COH = Controlled Ovarian Hyperstimulation

COW = Curse of Womanhood (menstruation)

CP = Cervical Position

CVS = Chorionic Villae Sampling

D&C = Dilation & Curettage

D&E = Dilation & Evacuation

DE = Donor Eggs

DES = Diethylstilbestrol (a synthetic estrogen)

DHEAS = Dihydroepiandrosterone Sulfate

DI = Donor Insemination

DIPI = Direct Intra-peritoneal Insemination

DOST = Direct Oocyte-Sperm Transfer

DPO = Days Post-Ovulation

DPR = Days Post-Retrieval

DPT = Days Post-Transfer

DP3DT = Days Post 3-Day Transfer

DP3DT = Days Post 5-Day Transfer

Dx = Diagnosis

E2 = Estradiol

EB, EMB = Endometrial Biopsy

EDD = Estimated Due Date

ENDO = Endometriosis

EPO = Evening Primrose Oil

EPT = Early Pregnancy Test

ET = Embryo Transfer

ETF = Embryo Toxic Factor

ETA = Embryo Toxicity Assay

EW, EWCM = Egg-white Cervical Mucus

F-M

FBG = Fasting Blood Glucose

FET = Frozen Embryo Transfer

FHR = Fetal Heart Rate

FP = Follicular Phase

FSH = Follicle Stimulating Hormone

FTTA = Fertile Thoughts To All

FV = Fertile Vibes

FWW = 4-Week Wait (from one insemination to the next insemination)

GD = Gestational Diabetes

GIFT = Gamete Intra-fallopian Transfer

GnRH = Gonadotropin Releasing Hormone

GP = General Practitioner

GTT = Glucose Tolerance Test

HbA1c = Glycosylated Hemoglobin (also called Glycohemoglobin)

hCG, HCG = Human Chorionic Gonadotropin

HCP = Health Care Practitioner

HEPA = Hamster Egg Penetration Assay

hMG, HMG = Human Menopausal Gonadotropin

HPT = Home Pregnancy Test

HRT = Hormone Replacement Therapy

HSC = Hysteroscopy

HSG = Hysterosalpingogram

IBT = Immunobead Binding Test

ICI = Intra-cervical Insemination

ICSI = Intra-cytoplasmic Sperm Injection

IF = Infertility

IGTT = Insulin and Glucose Tolerance Test

IM = Intra-muscular (WRT injections)

IOR = Immature Oocyte Retrieval

IR = Insulin Resistant

ITI = Intra-tubal Insemination

IUFD = Intra-uterine Fetal Demise

IUGR = Intra-uterine Growth Retardation

IUI = Intra-uterine Insemination

IVC = Intra-vaginal Culture

IVF = In Vitro Fertilization

IVIg = Intravenous Immunoglobulin

LAD = Leukocyte Antibody Detection Assay

LAP = Laparoscopy

LH = Luteinizing Hormone

LIT = Leukocyte Immunization Therapy

LMP = Last Menstrual Period (start date)

LO = Love Olympics (sex)

LP = Luteal Phase

LPD = Luteal Phase Defect

LSP = Low Sperm Count

LUF, LUFS = Luteinized Unruptured Follicle Syndrome

MAI = Miscarriage After Infertility (mail list)

MC, m/c, misc. = Miscarriage

MESA = Microsurgical Epididymal Sperm Aspiration

MF = Male Factor

MIFT = Micro Injection Fallopian Transfer

N-Z

NEST = Non-surgical Embryonic Selective Thinning

NI = Natural Insemination (ie sex)

NK = Natural Killer Cells (CD56+)

NORIF = Non-stimulated Oocyte Retrieval In (office) Fertilization

NP = Nurse Practitioner

NSA = Non-surgical Sperm Aspiration

O, OV = Ovulation

OB = Obstetrician

OB/GYN = Obstetrician/Gynecologist

OC = Oral Contraceptives

OD = Ovulatory Dysfunction

OHSS = Ovarian Hyperstimulation Syndrome

OPK = Ovulation Predictor Kit

OPT = Ovulation Predictor Test

OTC = Over The Counter

OW = Overweight

P4 = Progesterone

PA = Physician’s Assistant

PAI-1 = Plasminogen Activator Inhibitor-1

PCAO= Polycystic Appearing Ovaries

PCO = Polycystic Ovaries

PCOD = Polycystic Ovary Disease

PCOS = Polycystic Ovary Syndrome

PCP = Primary Care Physician

PCT = Post Coital Test

PESA = Percutaneous Epididymal Sperm Aspiration

PG = Pregnant

PGD = Pre-implantation Genetic Diagnosis

PI = “Partial” Insemination (The man enters the woman just before ejaculation. This is sometimes also referred to shortened or rapid intercourse. The idea behind it is to limit the duration of the actual physical contact to the minimum). Not common.

PI = Primary Infertility

PID = Pelvic Inflammatory Disease

PIO = Progesterone in Oil

PLI = Paternal Leukocyte Immunization

PMS = Pre-menstrual Syndrome

PNM = Perinatal Mortality

POC = Products of Conception

POF = Premature Ovarian Failure

PROM = Premature Rupture of Membranes

PTSD = Post-Traumatic Stress Disorder

PZD = Partial Zona Dissection

RE = Reproductive Endocrinologist

R-FSH, R-hFSH = Recombinant Human Follicle Stimulating Hormone

RI = Reproductive Immunologist

RIP = Reproductive Immunophynotype

ROS = Reactive Oxygen Species

RPL = Recurrent Pregnancy Loss

RSA = Recurrent Spontaneous Abortion

Rx = Prescription

SPA = Sperm Penetration Assay

SA = Semen Analysis

SART = Society of Assisted Reproductive Technology

s/b, S/B = Stillbirth

SCORIF = Stimulated Cycle Oocyte Retrieval In (office) Fertilization

SHG, SonoHSG = Sonohysterogram

SI = Secondary Infertility

SIS = Saline Injection Sonogram

SLE = Systemic Lupus Erythematosus

SMC = Single Mother by Choice

SPA = Sperm Penetration Assay

STD = Sexually Transmitted Disease

SUZI = Sub-zonal Insertion

T4 = Thyroxine

TEBG = Testosterone-Estradiol Binding Globulin

TESA = Testicular Sperm Aspiration

TESE = Testicular Sperm Extraction

TET = Tubal Embryo Transfer

TL = Tubal Ligation

TNF = Tumor Necrosis Factor

TR = Tubal Reversal

TRH = Thyroid Releasing Hormone

TSH = Thyroid Stimulating Hormone

TTC = Trying to Conceive

TTCAR = Trying to Conceive after Reversal

TUFT = Trans-uterine Fallopian Transfer

TWW = Two Week Wait (from insemination to menstruation/pregnancy)

Tx = Treatment

TYB = Test Yolk Buffer (used to preserve the life of shipped sperm)

TZD = Thiazolidinediones

UR = Urologist

US, u/s = Ultrasound

UTI = Urinary Tract Infection

V = Vasectomy

VR = Vasectomy Reversal

WBC = White Blood Cells

WHR = Waist to Hip Ratio

WNL = Within Normal Limits

ZIFT = Zygote Intra-fallopian Transfer

Common Acronyms

AMAP = As Much As Possible

AFAIK = As Far As I Know

ASAP = As Soon As Possible

BB = Bulletin Board

BBL = Be Back Later

BBW = Big Beautiful Women

BTW = By The Way

DD = Dear Daughter, Darling Daughter

DH = Dear Husband, Darling Husband

DHAC = Don’t/Doesn’t Have A Clue

DITD = Down In The Dumps

DP = Dear Partner, Darling Partner

DS = Dear Son, Darling Son

DW = Dear Wife, Darling Wife

FAQ = Frequently Asked Question(s)

FWIW = For What It’s Worth

HTH = Hope This Helps

IIRC = If I Recall/Remember Correctly

IMHO = In My Humble Opinion, In My Honest Opinion

IMO = In My Opinion

IRC = Internet Relay Chat

LMK = Let Me Know

LOL = Laughing Out Loud (or Lots Of Luck)

MIL = Mother In-law (also FIL, SIL, BIL for the others)

NBD = No Big Deal

NG = Newsgroup

OT = Off Topic

OTOH = On The Other Hand

PITA = Pain In The Ass

POA = Plan Of Action

POV = Point Of View

PV = Positive Vibes

ROTFL = Rolling On The Floor Laughing

ROTFLOL = Rolling On The Floor Laughing Out Loud

ROTFLMAO = Rolling On The Floor Laughing My A** Off

SO = Significant Other

TIA = Thanks In Advance

TTFN = Ta Ta For Now

TTYS = Talk To You Soon

TTYTT = To Tell You The Truth

WB = Welcome Back

WF = Warm Fuzzies

WRT = With Respect To

WWW = Wise Women of the Web

YMMV = Your Mileage May Vary

Links to sites that might help with this surrogacy lingo:

http://www.resolve.org/support/Managing-Infertility-Stress/infertility-acronyms.html

http://www.resolve.org/support/Managing-Infertility-Stress/infertility-acronyms-part-two.html

https://www.shadygrovefertility.com/blog/diagnosing-infertility/learn-the-lingo-infertility-acronyms-and-abbreviations/

http://www.babycenter.com/community-help-abbreviations

Try every avenue

Jimmy Fallon, Wife Had "Awful" 5-Year Fertility Struggle Before Using Surrogate

"Try every avenue; try anything you can do. You'll end up with a family, and it's so worth it. It's the most 'worth it' thing." Jimmy Fallon on pursuing #surrogacy after a 5 year struggle with infertility with wife Nancy Juvonen.

http://www.usmagazine.com/celebrity-moms/news/jimmy-fallon-wife-had-awful-5-year-fertility-struggle-before-using-surrogate-2013138

So true

Counselling Before, During and After Pregnancy

The “Families through Surrogacy” Surrogacy conference in Brisbane in June 2016, raised a number of interesting topics.

One very interesting perspective raised by a number of psychologist guest speakers, is the importance of counseling before, during and after the pregnancy.

Michael Condon - Clinical Psychologist (contact: michael.condon@qfg.com.au) spoke at the conference about “Avoiding and Responding to Disputes”, of which counseling is an important tool.  

Condon identified that pre-counseling is required, and often a requirement of approval for a surrogacy arrangement.  The Western Australian approach is to have a counselor available at the clinic and also a psychology assessment during the application process.  There is no requirement within the Surrogacy Act 2008 of post birth counseling.

Condon indicated that during pregnancy three monthly catch ups were preferred. If this was not possible then he recommends that at least the surrogate, her partner and the intending parents to catch up every two months.

A number of the counselors at the conference also recommended counseling post birth.

The Queensland Surrogacy Act 2010, requires post birth counseling.

“After the birth of the child the birth parents and intended parents must get a surrogacy guidance report from an appropriately qualified and independent counselor after your baby is born. This cannot be the same counselor you spoke with before entering into the surrogacy arrangement.”

Source:

http://www.babycentre.co.uk/a536333/your-body-after-the-birth

This largely addresses legal requirements that relates to ensuring an appropriate parenting order is prepared.

Surrogates talk of the importance of understanding the post birth emotions. The Intending Parents can be distracted with a beautiful new demanding baby and anecdotally the surrogate can feel isolated.  In addition, the surrogates talk of some very powerful physical reactions to giving birth that can be difficult to rationalize and can impact on their mental wellbeing.

There are many physical impacts of pregnancy, the contracting of the uterus occurs after birth is one.

“Your uterus (womb) is shrinking back to its normal size and position, and you may have afterpains as it contracts down. Afterpains feel like mild labour contractions, and often happen while you are breastfeeding. This is because the hormone oxytocin, which encourages your uterus to contract, is released while you're feeding. It also can cause redder or heavier blood loss.”

Source:

http://www.babycentre.co.uk/a536333/your-body-after-the-birth#ixzz4BGStPRfY

Anecdotally, the contraction of the uterus can occur when the surrogate is cuddling the baby after birth and the baby is nuzzling for food. Obviously, this physical reaction can lead to a more intense emotional response.

A number of surrogacy web sites identify the importance of closure post the birth of the child. Birth and post birth, is physically demanding and potentially a mentally difficult time for surrogates.  

The following is an extract from the Creating Families website that identifies trends counselors are noticing in the surrogacy sector.

“As professionals, we can often help individuals understand the importance of obtaining some sense of closure. Perhaps, one of the clearest and most important examples of this issue is the birth plan and good-byes at that time. Given the awkwardness, the exhaustion, the anxieties, and the newness of it all, it is all too common for the long awaited "ending" not to be as well planned as other stages. My partners and I find ourselves giving more and more attention to birth plans, simple rituals, symbolic and tangible acknowledgments. Surrogates need to feel validated and trusted, not rushed. Couples need to be present with her and create a feeling of safety and comfort for themselves. A respectful, warm, and moving birth/hospital stay helps the surrogate to minimize feelings of exploitation or emptiness. Attention to closure helps the prospective parents reduce anxieties about the unknown, helps them feel secure in the relinquishment, and provides a positive story to tell their child. Additionally, having some clear understanding about the post-birth contact frees both parties from misinterpreting behavior.”

Source:

http://www.creatingfamilies.com/intended-parents/?counseling-issues-and-surrogate-parenting-132

The Australian and New Zealand Infertility Counsellors Association, have developed “ANZICA Surrogacy Guidelines - Post Delivery Counseling” to assist with this difficult time.
“Follow up counselling after treatment, whether successful or not, is highly recommended and should be available to all participants. In some jurisdictions, there is a formal requirement for counselling throughout the pregnancy and post delivery which may be provided by the external assessment counsellor. This necessitates a review of the counselling ‘contract’ to move from an assessment role to a supportive counselling role. In other jurisdictions a post treatment surrogacy guidance report, for use in an application for a parentage order, must be prepared by an independent and appropriately qualified counsellor.”

Source:

http://www.fertilitysociety.com.au/wp-content/uploads/110829-ANZICA-SURROGACY-GUIDELINES-FINAL.pdf

Post birth counseling seems like a reasonable approach to this phase of the surrogacy process. There are some interesting statistics about the emotional responses of surrogates in other countries. In Iran, research has been in the emotional effect on the surrogate when she gives the child to the intended parents.

“Important biological bonds are established between mother and her fetus during pregnancy. One of the most concrete examples of the importance of this bond comes from knowledge of fetal-maternal physiology. Oxytocin hormone plays a crucial role in priming the pregnant mother to respond in accordance with her natural maternal instincts. Therefore, there is a concern that the rented mother establishes such a firm emotional bonding to the fetus that separation of the newborn after giving to commissioning couple may be very difficult because she believes that the baby belongs to her and not to the commissioning couple. There is a risk of postpartum depression and psychologically harmful feeling of guilt or anger in these women.”

Source:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126251/

Iranian Journal of Reproductive Medicine. 2014 Jul; 12(7): 471–480, Emotional experiences in surrogate mothers: A qualitative study, Hoda Ahmari Tehran, Shohreh Tashi, Nahid Mehran, Narges Eskandari, and Tahmineh Dadkhah Tehrani.

This paper refers to statistics from England. Jadva’s research in “Surrogacy: the experiences of surrogate mother” showed that “all of the surrogate mothers in postpartum period, with no doubt, delivered the babies according to previous agreement. The follow up of those women showed that 32% of women had emotional and psychological problems for several weeks after losing the babies. After a few months, this rate decreased to 15% and continued until 1 year only in 6% of cases.

Source:

Jadva V, Murray C, Lycett E, MacCallum F, Golombok S. Surrogacy: the experiences of surrogate mother. Human Reproduction. 2003;18:2196.

The Iranian study, “Emotional experiences in surrogate mothers”, identifies that surrogates have a positive experience however counseling is required.

“Our study showed mainly the positive experience of surrogate mothers however, surrogacy needs special care in various aspects that its management is very important and requires deep consultation to select suitable host. Meanwhile, counseling should be continued for surrogate mothers during and after pregnancy.”

Source:

Iranian Journal of Reproductive Medicine. 2014 Jul; 12(7): 471–480. Emotional experiences in surrogate mothers: A qualitative study. Hoda Ahmari Tehran, Shohreh Tashi, Nahid Mehran, Narges Eskandari, and Tahmineh Dadkhah Tehrani,

Anything that clinics, intending parents and medical practitioners can do to support surrogates post birth and therefore reduce the potential for post birth mental health complications should be undertaken.