1. 1 CHILD CENTERED PRACTICE FOR DONOR CONCEPTION Kris A. Probasco, LSCSW, LCSW Adoption and Fertility Resources 1129 W. Kansas, Suite B Liberty, MO 64068 (816) 781-8550 Email: cca144@sbcglobal.netcca144@sbcglobal.net Website: clinicalcounselingassociates.com

2. 2 And Donor Conceptions Should Not Either

3. 3 HISTORY OF DONOR CONCEPTIONS 1884 – First Documented Case of Donor Sperm Insemination, R. Snowden, Artificial Reproduction, A Social Investigation, Artificial Reproduction; a Social Investigation, 1983 1983 – First Documented Case of Egg Donation – UCLA Medical Center 1988 – The Office of Technology Assessment estimates that 30,000 U.S. children were born via donor insemination during 1986-87 In the U.S. there is no accurate tracking or record keeping, so it is likely there are many more donor conceptions, probably in the 100,000+. 1997 – First Case of Embryo Placement and Adoption- Snowflakes, Nightlight Adoption, Inc. 612,000 Frozen Embryos awaiting decisions about their outcome, 2011 California State Fulton Research Annually there are approximately 25,000 to 30,000 (Evan B. Donaldson Adoption Institute) traditional adoptions and 9,341 (2011) # of U.S. Visa for international adoptions.

4. 4 Services of Advance Reproductive Medicine Fertility Clinic General Infertility & Recurrent Miscarriage Treatment Comprehensive evaluation & diagnosis Controlled Ovarian Hyperstimulation (OCH) with Injectable Medications – Gonadotropinas (FSH & LH) Intra uterine insemination (IUI) Donor insemination services Recurrent miscarriage treatment – TLC program IVF and ART Egg Retrieval In Vitro Fertilization (IVF) – PDF Embryo transfer (ET) Intracytoplasmic sperm injection (ICSI) Assisted Hatching (AH) Blastocyst culture Embryo freezing Oocyte freezing Ovarian tissue freezing Preimplanation genetic diagnosis (PGD)

5. 5 Services of Advance Reproductive Medicine Fertility Clinic Third Party Parenting Donor Egg IVF Surrogacy Reproductive Endocrinology PCOS Hirsutism Hyperprolactinemia Menstrual disorders Amenorrhea Congenital anomalies of the reproductive organs Advanced Reproductive Surgery Diagnostic and operative laparoscopy Diagnostic and operative hysteroscopy Microsurgical tubal anastomosis (Tubal ligation reversal) Laser surgery Endometriosis treatment with minimally-invasive surgery Myomectomy (robotic surgery available)

6. 6 Services of Advance Reproductive Medicine Fertility Clinic Andrology/Laboratory Services Semen analysis Strict sperm morphology Viability staining Post vasectomy check Anti-sperm antibodies Semen cryopreservation and storage Semen preparation for Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) Sperm identification and cryopreservation during sperm aspirations Donor storage and processing Endocrinology Laboratory ß hCG—pregnancy determination and monitoring Estradiol—stimulation cycle monitoring and other diagnosis Follicle stimulating hormone—ovarian function, spermatogenesis Luteinizing hormone—ovulation monitoring, androgen production Progesterone—luteal phase monitoring Prolactin—pituitary function DHEA-S—adrenal function 17- alpha OH progesterone— adrenal function Testosterone—gonadal function

7. 7 Services of Advance Reproductive Medicine Fertility Clinic Embryology Laboratory In Vitro Fertilization (IVF) and Embryo Transfer Intracytoplasmic Sperm Injection (ICSI) Sperm retrieval, identification, processing and cryopreservation Embryo culture, cryopreservation, storage, thawing and transfer

8. 8 PARENTAL ACCEPTANCE OF NEXT BEST ALTERNATIVES FOR BRINGING A CHILD INTO FAMILY Accepting the Differences, H.D. Dirk, Shared Fate, 1964, Making Peace with Decisions and Genetic Family Grieving the Loss of Genetic Child To Acknowledgement and Acceptance Emotional Conception – Physical Conceptions. Recognition of the fact that children have genetic parents, legal parents and raising parents. When a child is separate from their genetic history, there are adoption issues.

9. 9 The child needs to be accepted as an individual with a unique genetic history Parents’ role to become the child’s advocate Obtain all available information about the social, biological and genetic history. The parents are responsible for the child’s narrative of coming to the family. Consumer Advocacy – Open Identified Sperm and Egg Donors and open adoption for embryo placement Check with the Donor Sibling Registry for numbers of half siblings. Use the registry for contacts with egg donor (contracts) – use of an adoption agency for embryo placement

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11. 11 Children have the need to be recognized as full and equal members of their family It is the parents’ responsibility to secure legal connection to the child Many states have legislation documentation for sperm donation, so no further legal requirements after birth In Kansas and Missouri, successful finalization of a step-parent adoption for egg donation and a finalized adoption for an embryo placement

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13. 13 Children need to grow up knowing the truth about who they are and how they joined the family Healthy relationships are built on trust and honesty. The burden of reproductive events, decisions and outcomes belong to the parents, not the child The parents’ job is to speak the truth and tell their child all they know about their donor conception Follow developmental processes in telling of the story – goal is for child/adult to say that they don’t remember being told because they always knew how they came into the family

14. 14 RESOURCES XYANDME.COM Infertility Network – Canada Donor Sibling Registry

15. 15 Donor registries have already been established in Norway, Germany, Netherlands, New Zealand, United Kingdom, Sweden, Finland, Switzerland, Austria and the Australian States of Victoria, New South Wales and Western Australia. Croatia is considering medical fertilization law to establish a national donor registry. On May 19, 2011, British Columbia, Canada Supreme Court declared unconstitutional the legislation that denied donor offspring the same rights as adoptees. The ruling will make British Columbia the first province in Canada to ban anonymity for sperm and egg donors. Currently under appeal from the British government.

16. 16 Recent Articles The New York Times, 9/5/2011, One Sperm Donor, 150 Offspring The Seattle Times, 4/4/12, Woman, 68, Perseveres in Quest for Donor Father and Her Identify Time, 4/16/12, Frozen Assets, America is the largest exporter of sperm People Magazine, 3/19/12, Are Sperm Donors’ Kids at Risk?

17. 17 Need for a Federal Donor Registry to ensure that all donor conceived children/adults have the right to know their biological parents when they turn 18 and family medical history. Congressman Jared Polis, Colorado, and Congresswoman Lynn Jenkins, Kansas, are interested in this legislation. Please contact your state senator/congress person and ask them to support a Federal Donor Registry