Surrogacy for Gay Men

The Ongoing Gay Legacy of CT Fertility

Roughly 90% of the patients at CT Fertility are gay men. And that's not by accident.

**CT Fertility is now closed. Message from CT Fertility: "Thank you for entrusting your care to us for the past 25 years. We wish each and every one of you all the best."**

Here's a shocker: it turns out us gay dudes don't know diddly about the female reproductive system. That will change pretty rapidly, though, if you step foot inside the offices of CT Fertility.

"Gay male couples tend to have no clue about pregnancy when they first walk in," laughed Medical Director at CT Fertility, Dr. Melvin H. Thornton II. "I'm sometimes accused of giving out too much information, but I'd rather give too much than too little."

The bulk of his patients are gay, which means Dr. Thornton, who has over 22 years of experience in the fertility world, has become something of a part-time professor in addition to a medical professional as he shepherds gay men and couples through the process of creating embryos.


"These guys just want a family, that's what they know," said Linda Vignapiano, Director of Clinical Operations for the East Coast for CT Fertility's parent company, IntegraMed. "So they have no idea what PGS is, for example, so we try to teach them."

"Really? That's crazy," I laughed along with her.

"That's Preimplantation Genetic Screening," Linda clarified a moment later, likely sensing, like most gay men, I had no idea what she was talking about. (Hey, admit it, you didn't know either.)

Herein lies how CT Fertility is setting itself apart. Particularly for an industry whose entire goal is to help make dreams of parenthood come true, the process can often feel incredibly sterile and impersonal. But at CT Fertility—whether you like it or not—you're going to be kept in the loop.

***

Roughly 90% of the patients at CT Fertility are gay men, and this is not by accident. Over 25 years ago, a man by the name of Dr. Michael Doyle founded CT Fertility with the explicit goal of helping LGBTQ people start their families.

"He was really a trailblazer," Linda said, noting Dr. Doyle worked hard to establish CT Fertility as an early leader in the LGBTQ community.

Two years ago, Dr. Doyle left clinical practice and was replaced by a man who spent 15 years as the Medical Director of the Columbia University IVF program, and nine years as Director of their donor egg program—Dr. Melvin H. Thornton II.

Dr. Melvin H. Thornton II

It's an intimidating name. But you need just a couple of minutes with Dr. Thornton to understand why Dr. Thornton fits in comfortably at CT Fertility.

"I started my practice initially in Southern California, where everyone talks to everybody," said Dr. Thornton. When he moved to New York to begin working at Columbia, he realized something about East Coasters: "Nobody talks," he said.

If you walk into Dr. Thornton's office, however, not talking is not an option.

"The first thing I like to do in a consultation is ask questions that sometimes surprise them," said Dr. Thornton. "I ask how they met, or how long they've been together. I ask how their engagement was."

Next, Dr. Thornton does something else you might not expect from a man with a roman numeral after his name: mental visualization exercises. Close your eyes and look into your future 10 years, he'll say. Imagine yourself in Central Park on a nice summer day.

How many children do you see with you?

"The number is usually controversial," he says. "One partner says two, the other says three. Then they'll look at each other, and think: wait, what do you mean? I want them to help them have the family they really want, but they need to get on the same page."

But he also wants to make sure intended parents never get too bogged down in the details. "This whole process is about family," he said. "It's important to never lose sight of that."

***

Both Linda and Dr. Thornton, with their combined experience of nearly 50 years in the fertility industry, say working with gay men is a pleasure. Working for straight couples and women can be more difficult, they say, since they are often treating infertility, or attempting to conceive at an advanced age, meaning success is less of a given.

"When gay couples come in, you typically have a donor egg, healthy sperm and a gestational carrier with a proven uterus," said Dr. Thornton. "You can pretty much be confident they will have the family they're looking for."

"I had infertility myself," said Linda Vignapiano. "I know what it's like. So working with gay couples—everybody is just happy and excited."

Linda Vignapiano

The success rate for gay men may be much higher, but that doesn't mean the process is any simpler. In fact, in many ways, it can be much more complicated.

"In the old days, I just had a man and a woman and I knew what I was doing," Linda said. "Now? I have two men, an egg donor, a surrogate, and a surrogacy agency I interact with. It's a party!"

What this means for CT Fertility, specifically, is that the clinic has learned to adapt its business practices to anticipate and accommodate the different needs of their LGBTQ intended parents.

For instance, at other fertility clinics with less experience working with gay men, you may end up with one coordinator for the intended parents, another for the surrogate, and yet another for the donor. At CT Fertility, Linda says continuity is key: intended parents, donors and surrogates all have the same coordinator.

"At some of the larger IVF clinics, we've been told by patients that it can feel like a conveyor belt—they never get the same person twice," she explained. At CT Fertility, "you're not going to get a 'doc of the day,'" she continued, meaning if you are a patient of Dr. Thornton's to start with, you will stay that way throughout the entire process, from your initial consult to your surrogate's transfer. "That feels good to our patients."

***

While no official numbers exist, many fertility clinics have reported a rise in the number of gay couples seeking to start their families via surrogacy in recent years, thanks in large part to marriage equality and increased societal acceptance of LGBTQ parents.

"The biggest thing I've seen change for gay men in recent years is the simple reality that they can have a child this way," said Dr. Thornton. "You'd be surprised, I've talked to lots of gay men who didn't know this was available to them."

But what work still needs to be done in order to make surrogacy more widely available to gay men?

First and foremost: the price tag remains a major sticking point. Though some financial assistance programs like the one offered by Men Having Babies has helped put surrogacy within reach of more gay men and couples, the option will remain inaccessible until it becomes more affordable.

Dr. Thornton says he's encouraged that a few larger companies, like Deutsche Bank and Google, have begun to provide fertility services for gay couples. "But everyone should have a right to fertility," he said. "If you're a gay man who works for a company that has IVF coverage, you should be allowed to create embryos."

And while attitudes around gay men and surrogacy are improving by the years, some stigmas continue to linger.

"Somebody needs to educate the FDA," Linda said, explaining that, just like with blood donation, gay men are considered "high risk" sperm donors by the government and are thus automatically barred from being considered a "qualified" tissue donor. In practice, all this means is the surrogate needs to sign a waiver acknowledging the "increased risk."

"But it just really sticks in my craw," Linda said. "It's not even like they are 'donating' anything—these are their babies!"

Still, Dr. Thornton says we are lucky to have the option of surrogacy at all in the United States. "In certain countries, you can't even talk about surrogacy," he said. "So it's great to have the reproduction freedom we have, I just wish it was more widely available to everyone."

With states like New York and New Jersey looking to legalize surrogacy this year, and advocates pushing more businesses to cover fertility treatments for LGBTQ couples, it's clear the option is likely to soon become available to more gay men.

And when that happens, the staff at CT Fertility will be there, eagerly waiting to educate you.

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Surrogacy for Gay Men

5 Questions for Gay Dads Considering Twins in Their Surrogacy Journey

To twin or not to twin: it's a question every gay dad contemplating surrogacy will have to face at some point.

Gay dads-to-be who are creating embryos for surrogacy have a big decision to make: who will be the bio dad? Some dads would BOTH like to be bio dads, and express an interest in having twins, where one baby is biologically related to each dad. The decision to do a Multiple Embryo Transfer (MET) which would possibly lead to a twin pregnancy is a big one, with much to consider in addition to bringing home two bundles of joy from the hospital.

Circle Surrogacy & Egg Donation speaks with gay intended parents every day about the options they have to grow their families, including embarking on a twin journey.

Here are 5 questions to ask yourself if you're considering a twin pregnancy:

1. Am I ready for my surrogacy journey to cost more?

With an average singleton surrogacy journey costing anywhere between $110,000 and $120,000 (excluding IVF), intended parents should prepare for additional fees associated with a twin pregnancy. First, your surrogate will be paid additional compensation to carry twins. Second, the maternity expenses are typically twice as high with a twin pregnancy, as high risk OBGYNs are often involved. There can also be risks to the babies with a twin pregnancy. We have found that twins can be born one month early, with roughly half of twins needing to spend time in the NICU (Newborn Intensive Care Unit). At Circle, we have seen the average cost in the NICU approach $100,000.

2. Have I spoken to my IVF Doctor?

Your IVF clinic is your best resource for understanding what it means to do a multiple embryo transfer and try and for twins. There are some IVF clinics that will allow any IPs that would like to try for twins to transfer 2 embryos, as long as the IPs and surrogate fully understand the risks. However, other clinics will not transfer 2 embryos unless there's a medical reason. You should consult your IVF doctor.

3. Have I discussed twins with my surrogacy agency?

It's important to discuss a twin pregnancy with your agency who will be supporting you and your surrogate throughout your journey. Circle Surrogacy, for example, would support Intended Parents on a twin journey if they make an informed decision to have a twin pregnancy; and Circle would ensure the Intended Parents fully understood the risks associated with transferring two embryos. Considerations include:

  1. A twin pregnancy provides risks to the surrogate and to the babies.
  2. The maternity expenses are typically twice as high with a twin pregnancy, as high risk OBGYNs may be involved.
  3. There are also risks for the children. On average, we find that twins are born one month early, roughly half of twins end up in the NICU and, in our experience, incurring NICU fees.
  4. Matching Intended Parents who want twins may take longer, as many surrogates are either not medically approved to carry twins or are unwilling.
  5. The overall cost of the journey will be greater as complications often occur, most deliveries are via c-section and surrogates often end up on bedrest.

4. Am I ready to care for two babies?

Caring for one baby can feel overwhelming at first, so caring for TWO babies (double the feedings and diapers!) may require additional help and support. You should be prepared to speak to your IVF clinic and agency about your plan for caring for twins once they arrive.

5. Am I open to hearing about doing a 'dual journey' instead of a twin pregnancy?

An option to doing a twin pregnancy is doing what is called a dual journey: when two surrogates are pregnant at the same time with singletons with staggered due dates. Scott Buckley, VP of Client Services at Circle Surrogacy, recommends dual journeys – or sibling journeys – as options to a twin pregnancy: "With a dual journey or sibling journey, there are fewer expenses because there are fewer risks with singleton pregnancies and births. Intended Parents will receive a discount on agency fees for a second journey. Plus, when parents decide to do a sibling journey and work with the same surrogate, their discount is doubled. Essentially, you grow your family with two babies without the risk of a multiples pregnancy."

If you're considering growing your family with twins, the first step is to talk with your IVF clinic, and see what your doctor recommends. From there, speaking with your surrogacy agency will help you understand what a twin pregnancy means for costs and fees, as well as for matching times and surrogate availability. There are a few options to have two bio dads in your family, you just need to find the one that works best for you.

Researching surrogacy but feel like it's all Ancient Greek to you? You're not alone! The surrogacy process is filled with jargon, so we've started this surrogacy glossary of commonly used terms every gay dad should know as he embarks on the surrogacy journey.
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Surrogacy for Gay Men

What Professionals Will I Work With on a Surrogacy Journey?

There will be LOTS of people involved in your surrogacy journey. Kristin Marsoli of Circle Surrogacy breaks down the team of people you can expect to work with.

A surrogacy journey, while monumental, is also a complex process with multiple milestones, many of which are new territory for intended parents. You will likely form the strongest relationships with your egg donor and surrogate, however there are many other professionals who you'll encounter on your journey who will educate and support you on your way to parenthood.

Here are the types of professionals you can expect to work with on your surrogacy journey working with an agency such as Circle Surrogacy & Egg Donation:

Parent Outreach Team

When you start your research on surrogacy and surrogacy agencies, if you contact Circle Surrogacy, your first point of contact will be a member of our Parent Outreach Team. This person solely supports intended parents at the very beginning stages of their journeys, before they've signed on with an agency. The Parent Outreach Team is a wonderful resource to answer questions about the surrogacy process, surrogacy costs, how to choose an agency and more. At Circle, many of our Parent Outreach Associates are also parents through surrogacy, so they can share their experiences and understand exactly what it's like to be in your shoes. When you have your surrogacy consultation, you'll meet with a Parent Outreach Associate and a Lawyer to discuss your personal surrogacy needs and journey. Your Parent Outreach Team will support you through signing on with the agency.

Circle's Parent Outreach Team

Egg Donation Matching Coordinator

It's time to match with the first of two women who will be very important in your journey to parenthood: your egg donor! Selecting an egg donor may come easy to some, but others may take more time determining their perfect match. Our egg donor coordination team will help you find the right egg donor to meet your needs. They will help you navigate the egg donor database and coordinate your egg donor match.

IVF Doctor and Clinic Coordinators

You'll work closely with your IVF clinic professionals, including coordinators and, especially, your doctor. Your IVF doctor will advise you on your IVF journey and embryos, evaluate your egg donor and surrogate to determine they are ready for the process medically, and perform the egg retrieval and embryo transfer. Some intended parents come to surrogacy having already identified a clinic, others look for guidance in choosing a clinic that will best suit their needs.

Program Manager and Coordinator

Perhaps the professionals you will work the closest with will be your Program Manager (PM) and Program Coordinator (PC). As your journey support team, your PC and/or PM will be your day-to-day contact during your entire journey, from the moment you sign on with the agency, until the birth of your baby and beyond. Your PC and your PM ensure that you are meeting every milestone, having a smooth journey, and preparing for the arrival of your baby(ies).

Social Workers

Early on in your journey, you'll have an intended parent support call with one of the agency's social workers. During this call, you'll speak with the social worker about your upcoming journey, setting up expectations, talk about matching preferences and more. Social workers are also available to intended parents throughout their journey should they have a bump in the road, or if they need help navigating and talking through a situation.

L-R Alicia Abdella, Manager of Intended Parent Support and Social Worker, Jessica McCaffrey, Intended Parent Attorney and Scott Buckley, VP of Client Services

Lawyers (both at Circle and local attorneys)

During the surrogacy process you will work with a lawyer for the following milestones:

  • Drafting, negotiating and finalizing your surrogacy contracts
  • Establishing your parental rights
  • Safely returning home

Intended parents will be assigned a Circle attorney who will be part of the Coordination team. Parents can also expect to work with local counsel – lawyers who work out of the state from which their gestational carrier resides. Local counsel will help with establishing parental rights.

Surrogate Matching Team

A key milestone during your surrogacy journey is matching with your gestational carrier. At Circle, the Matching Manager – who is also a lawyer – presents intended parents with the profile of a gestational carrier whom she believes will be a great match. The match is based on a few criteria: legal fit, personality fit, geographic location and views on surrogacy. The Matching Team will help coordinate your first call with your potential surrogate, and work with you to find the most suitable match.

Trust Accountant Team

Each surrogacy operates a little differently; however if you work with a full-service agency such as Circle Surrogacy, a Trust Accountant will manage any outgoing payments to surrogates, egg donors and third parties. Upon matching, trust accountants keep intended parents informed of the monies needed to fund all expected expenses up until 6 months post delivery. They can also answer any financial questions intended parents may have.

Medical Billing Team

Intended parents will interact with the Medical Billing Team when they are matched with their gestational carrier. The team determines what intended parents can expect to pay for medical expenses from local monitoring, pregnancy and delivery, based on their specific case. The Medical Billing Team also reviews each medical bill from monitoring, physicians and the hospital prior to payment to ensure accuracy, and advocate for intended parents should medical facilities need to be called for any discrepancies.

Gestational Carrier's OBGYN

Around the 10th week of pregnancy, the IVF clinic will discharge your surrogate from their care and she will start seeing her OBGYN. Your surrogate will select her OBGYN that is local to her, and usually the same doctor she saw for her own pregnancies. Many intended parents attend the 20-week ultrasound with their surrogate, at which time they meet the OBGYN in person (in some cases, IPs have been "attended" ultrasound appointments via video on their surrogate's phone!).

The entire team at Circle

Hospital Staff

Your baby will be delivered at a hospital in your gestational carrier's home state; many times, it's the hospital where she delivered her own children. Circle recommends touring the Labor & Delivery section of your surrogate's hospital to help familiarize yourself with its staff and layout in advance. Many intended parents combine their visit for the 20-week ultrasound and the hospital tour. Touring the hospital with your surrogate enables you both to ask questions of the hospital staff and prepare for baby's delivery.

Embassy personnel (international intended parents)

International parents will work with their agency's legal team as well as local counsel to ensure they can return home safely. Some intended parents will need to travel to the embassy to secure travel documents for their baby(ies).

There are so many experienced professionals involved in a surrogacy and egg donation journey. It's important to understand with whom you'll be working throughout each milestone. While every agency operates differently – and an independent surrogacy journey will involve fewer agency professionals – these are the professionals intended parents can expect to work with on a journey with Circle Surrogacy. And because Circle is a full-service agency, many of the professionals mentioned above – outside of IVF clinics, local attorneys, hospital and embassy personnel – are all under one roof, making the management of your journey smooth and secure.

'Life Is Amazing': Congrats to Gay Dads Whose Families Recently Grew!

Help us congratulate gay dads on their recent births and adoptions last month!

Wishing all of these gay dads whose families expanded in the last month or so a lifetime of happiness! Congrats to everyone in our community on their recent births and adoptions!

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On Saturday, October 5, 2019, Philadelphia Family Pride will hold their 10th Annual Family Matters Conference from 9am to 3:30pm for LGBTQ parents, prospective parents and their kids of all ages at the University of the Sciences in West Philadelphia. The theme this year is "Telling Our Stories." Registration is now open!

In an interactive keynote, Anndee Hochman, author of the Philadelphia Inquirer's weekly "Parent Trip" column, will share highlights from her work as a journalist and memoirist. She'll invite conversation about the stories that shape us—what tales do we share? who does the telling? who is left out?—and how those stories, added up, are changing the world. Read her bio.

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The homestudy is the first step in the adoption process. In every state the homestudy is done a little differently, but all of them have the some combo of paperwork, trainings, and interviews. The homestudy can take anywhere from 2 months to 6 months to complete. Without it, you cannot adopt.

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Fatherhood, the gay way

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