Getting Started

MARCY AND ERIC had been trying to have a baby for several years with no luck. They'd been to many specialists and they'd tried everything their doctor suggested, without success. When their doctor finally suggested they explore surrogacy, rather than feeling excitement, they felt sad, ashamed, and hopeless. It was another six months before they called me and asked to talk about surrogacy. I met with them on and off for another six months while we explored their feelings of sadness and loss. Marcy especially needed to dig deep to uncover how she was feeling and to grapple with her excitement about being a mom in the context of what she would have to give up to get there. They eventually decided to proceed, and their surrogate, Annie, got pregnant on the first try. The pregnancy and delivery went smoothly, and Annie delivered a healthy baby girl. Still, every step of their process was fraught with sadness, loss, and regret. Until their baby was in their arms. From that moment on, they focused completely on the joy of raising their daughter. In an instant, the sorrow of their past was a distant memory.

Like Marcy and Eric, you may have some big emotional hurdles to overcome before you begin the process. But with the support of professionals, family, and friends, and by staying focused on the outcome — your future family — you will get there.

Sometimes couples embrace the idea of getting help from the start, once they realize it is the only viable option, and even enjoy the process. For others, picking up this book is exciting and joyful, because you are setting a plan in motion to realize your dream of becoming a parent. Regardless of where you are emotionally, there is no shame about needing assistance, no sense of failing at something, but rather a sense of hope and possibility.

Note:

Assisted reproductive technology (ART) is by definition assisted. That means other people are involved in the process of conceiving a child. Before delving into the particulars of the medical options and procedures, and the various pieces you will need to put in place, it's important to determine if building a family this way is the right path for you.

Different readers of this book will be in very different places emotionally and psychologically. If you've tried to conceive a child naturally and haven't had success, it's likely you're feeling some grief about that fact. For you, exploring assisted reproduction may feel as if you've failed at something everyone else can do without much trouble. You may feel as if something is deeply and inherently wrong with you, and now you must take this unusual path to become a parent. When you understand that to realize your dream of parenthood you might have to give something up — one or even both of your genetic contributions, and/or the ability to carry and give birth to your baby — the emotional and psychological impact is undeniable. Why me? You might ask. While I can't answer that question, I can tell you that your feelings are totally valid. And after twenty years of experience helping prospective parents through third-party assisted reproduction, I know that if you truly want to become a parent and you choose assisted reproduction, you will eventually come to embrace it.

There are many, many people who have a child in a nontraditional way, but if you think there is something wrong with or shameful about having a child through assisted reproduction, then you shouldn't do it. A shred of doubt or uneasiness can grow. You are using exceptional means to bring a life into the world, and you need to be completely sure where you stand. Otherwise your choices can affect your ability to parent, your relationship with your child, and your relationship with your partner if you have one. If you feel embarrassed, or if you have moral or ethical concerns, then it is important to sort those out before you begin. Sometimes just a few conversations with a mental health professional can really help. Often, just talking through all of your feelings, understanding where they come from and having the opportunity to express and process your grief, can help you work through your feelings and then make a powerful choice. If after all of these conversations and research you are still uncomfortable with enlisting the help of others to have your family, you should choose a different option. There are many children in the world in need of loving parents, and fostering and adoption are wonderful ways to build a family. Being aware of where you're at emotionally, spiritually, and financially is an important first step in the process, and I encourage you to take a moment to check in with yourself and your partner if you have one. This is one of the most important decisions one can make, and the more facts you have about the process, and the more in tune you are with how you feel about your options, the easier it will be to make the decision that's right for you and your family.

The (Potential) Puzzle Pieces

There are four key players in your assisted reproduction journey:

• A medical specialist, your reproductive endocrinologist

• A reproductive attorney

• A mental health professional specializing in fertility and ART

• A fertility insurance expert

While some hopeful parents choose to go it alone, or go it partially alone (enlisting the help of a few but not all of these people), I would advise against that. For a life decision as major as this one, you'll want all the support you can get. And it's very likely that at some point you will need — yes, need — these experts to guide you through the legal, medical, and psychological aspects of third-party assisted reproduction. With that strongly worded advice out there, let's dive into how these four professionals can help you on your journey.

A Medical Specialist

Assisted reproduction can help you conceive a baby using your own sperm, eggs, and womb, with the fertilization process managed and guided by a reproductive endocrinologist, a highly specialized medical doctor. Reproductive endocrinologists are trained and certified as an obstetrician/gynecologist (OB/GYN) and then as a specialist in reproductive endocrinology, which is the science of reproduction. These are the doctors that help people get pregnant.

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Fact: The American Society for Reproductive Medicine (ASRM) is a hub for reproductive endocrinologists and all other professionals in the field of ART and is a great resource for hopeful parents. An especially helpful tool is their collection of statistics online about how likely each reproductive endocrinologist is to help their patient get pregnant.

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Reproductive endocrinologists are highly trained medical professionals. That said, just like any doctor, they have different personalities, different bedside manners, and different ways of working with...