Infertile: Not able to conceive after a year of regular intercourse without contraception.
As common as infertility is for couples in Canada, the topic is not openly admitted to or discussed and this makes it difficult for couples to easily find information about how to deal with the problem when it arises. While couples who experience infertility probably do not want to go through a checklist to ensure they have everything they need in order to start a family, gathering information about what can be done to meet and overcome the challenges of infertility can help couples make decisions about how they want to approach infertility. Many couples turn to assisted human reproductive technology – surrogacy and in vitro fertilization as one way to tackle infertility. The following is a general list of what usually needs to be done if you are considering some form of third party assisted pregnancy – surrogacy or in vitro fertilization.
The first thing couples need to consider if they face infertility is to find a good doctor who deals specifically with this issue. Often family doctors can recommend or refer you to a specialist. Other options include contacting your provincial medical association such as the College of Physicians and Surgeons of Ontario. If you are considering some form of third party assisted pregnancy such as surrogacy, some doctors in the area have suggested that each party involved should have a separate doctor to look out for the welfare of only that party. This will minimize the potential for conflict if any problems arise. Some doctors who assist a couple in getting pregnant also deliver the baby while others do not. There are so many options and couples need to consider what is best for them after discussing the matter with the doctor of their choice.
Before starting a third party assisted pregnancy, for the health and well being of everyone involved, couples and donors or surrogates each need to see a psychologist to ensure that everyone is emotionally prepared to engage in such a process. Often couples are emotionally caught up with realizing their dream to start a family and they are not focused on the practical implications of what a third party assisted pregnancy will mean. For instance the issue of what a child conceived with the assistance of donated reproductive material will want to know may not be fully considered by a couple who faces the difficulty of infertility or a donor of reproductive material who wants to remain anonymous. An experienced psychologist can help everyone review the ethical and emotional ramifications involved in third party assisted pregnancies and help assess whether everyone is prepared to proceed. Canvassing such issues before committing to such a procedure is safer for everyone involved from an emotional and practical perspective. Again, to prevent potential conflict, it will be necessary to have separate psychologists for each party involved. Closely tied to the need for psychologists are counselors or support groups. Couples need to ensure that they have a strong support group or counselor they can depend on when the inevitable ups and downs of assisted reproduction occur. Donors and surrogates also need to have similar support networks available to openly discuss reservations or concerns that arise throughout such a process.
Costs are another issue to consider. Assisted reproductive technology procedures are not covered by provincial health care except in limited cases in Ontario. Private health insurance may cover some of the procedures and one couple who used a surrogate successfully won a federal court case to set a precedent that surrogate expenses qualified as medical expense eligible for a write off in the couple’s personal income tax return. Couples considering surrogacy and pregnancy using donated reproductive materials will likely need to pay for their own costs as well as the costs of the donor or surrogate to be involved. A general list of the costs that may arise in such procedures includes: medications, medical tests, hospitalization costs, costs of the actual transfer of materials, regular check ups, out of pocket expenses for the donor/surrogate, cost of storage of retrieved materials, and transportation costs for the donor.
It is wise for all parties involved in third party pregnancies to use a contract to address all the concerns and understandings the surrogate or donor and the couple hold before initiating any type of third party assisted pregnancy. This leaves less room for disagreements and problems down the road. Standard surrogacy and IVF contracts exist and many couples have opted to use these contracts instead of having completely new contracts drafted. It is important however that a lawyer review the contract terms to ensure that it is applicable and all of your concerns and issues are properly addressed whether you are the third party or the hopeful couple.
This article provides a skeleton as to what is involved for couples considering third party assisted pregnancies to meet the challenge of infertility. However if you want more information or you are further along in the process, most doctors involved in these processes and their staff have a wealth of information and resource professionals they can refer. In addition searching keywords such as surrogacy and infertility on the internet will provide a host of avenues you can read or contact.
Nancy Lam is a Toronto based IVF and surrogacy lawyer. Her office provides confidential legal advice about the law that governs donor IVF and surrogacy relationships in Canada. Find out what your legal rights and obligations are before you start your family.