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Selecting An ART Program (from ASRM)

When selecting an ART program, information is crucial. Important points for consideration include the qualifications and experience of personnel, types of patients being treated, support services available, cost, convenience, live birth rates per ART cycle started, and multiple pregnancy rates. Older programs have established live birth rates based on years of experience. Small and new programs may still be determining their live birth rates, although their personnel may be equally well qualified. Every couple wants to use the most successful ART program, but many factors contribute to the overall success of a program. For example, some clinics may be willing to accept patients with a low chance of success. A clinic may specialize in certain types of infertility treatment. Costs may vary among programs. A couple may prefer a program based on interpersonal interactions with the ART team, or may feel more confident in the recommended treatment plan. Consequently, it is not appropriate to compare programs based only on the published pregnancy rates.

Credibility is important too. Does the program adhere to the guidelines set forth by the American Society for Reproductive Medicine (ASRM)? Is the program a member of SART, a society affiliated with the ASRM? Is the IVF lab accredited by the College of American Pathologists or by the Joint Commission? These organizations require ART programs to have personnel on their staff who have been trained in reproductive endocrinology, laparoscopic surgery, sonography, hormone measurement, tissue culture technique, and sperm/egg interaction. Are the physicians board certified in reproductive endocrinology and infertility? Does the program report its results to SART/ CDC? The compiled results are published in Fertility and Sterility, the ASRM journal, and results are available on the SART web site at www.sart.org and the CDC’s web site at: www.cdc.gov/art. The above considerations and answers to the following questions, which may be asked of each program, will help you make an informed decision when choosing an ART program.

The decision to seek treatment for infertility is a viable one due to the assisted reproductive technologies available today. With patience, a positive attitude, and the appropriate treatment, most infertile couples will eventually experience the joys of parenthood.  For additional information, visit www.sart.org and www.cdc.gov/art.


Counseling Issues for Gay Men and Lesbians Seeking Assisted Reproductive Technologies (ART)

How are gay men and lesbians having children?
They are having children through heterosexual marriage, adoption, artificial insemination with donor sperm, and surrogacy and egg donation. Issues may arise medically, legally, socially and emotionally. Counseling prior to embarking on the path to parenthood, during the process, and after a family is formed is recommended.

Are parenting concerns of heterosexual couples different than those of gay or lesbian couples?
All potential parents share concerns about their ability to be good parents, the affordability of parenting, questions about the suitability of bringing children into a world like the one in which we live, and about how a child changes a person’s/couple’s life. Couples using ART may also share concerns about the biological connection to the child; conceiving with a third party; societal attitudes towards ART; educating family, friends, and the general public; and disclosure to the child and family. In addition, there are unique issues for gay and lesbian couples.

What unique issues are present for gay and lesbian couples?
These issues include internalized homophobia and societal homophobia. Internalized homophobia is a term used to represent the negative and distressing thoughts and feelings experienced by lesbians and gay men about their sexuality which are attributed to experiences of cultural heterosexism and victimization. Find a clinician who displays sensitivity and awareness of lesbian and gay clients’ unique issues.


What questions need to be addressed by gay and lesbian couples?

Before conception:
The first question many same-sex couples ask is whether or not it is OK to have a child. These couples may wonder if friends and family will support their choice and whether their children will suffer from having same-sex parents instead of having a mother and father. Confronting internalized homophobia, accepting oneself completely, and addressing unexamined feelings must also be addressed by the would-be parents.

During the fertility work-up:
ART options require decisions such as whose sperm or eggs to use and who will carry the child. Furthermore, the partner whose uterus, sperm or eggs were not used may question their status as a full and equal parent.

After a successful cycle:
The couple should decide what last name to use and what their children will call them. The couple should discuss how to talk to their children about their family. Parents are encouraged to tell age-appropriate truth and avoid lying or deceit. The couple may wonder how much to tell others about the details of their children’s conception (e.g., who was the sperm donor, etc.). It is suggested that parents share with others what feels comfortable and appropriate. Alternative Therapies or Complementary Medicine are terms for treatments and practices not typically used in conventional Western medicine.  Conventional medicine refers to the standard care that a patient receives from medical doctors (MD), doctors of osteopathy (DO) and other health professionals such as nurses, psychologists and physical therapists.  A practitioner of alternative therapies or complementary medicine may use herbs, acupuncture, chiropractic medicine, yoga, biofeedback, hypnosis, or homeopathy to treat a patient outside of standard care.

© 2012 The American Society for Reproductive Medicine • ASRM grants permission to photocopy this fact sheet and distribute it to patients.


Alternative Therapies or Complementary Medicine

Alternative Therapies or Complementary Medicine are terms for treatments and practices not typically used in conventional Western medicine.  Conventional medicine refers to the standard care that a patient receives from medical doctors (MD), doctors of osteopathy (DO) and other health professionals such as nurses, psychologists and physical therapists.  A practitioner of alternative therapies or complementary medicine may use herbs, acupuncture, chiropractic medicine, yoga, biofeedback, hypnosis, or homeopathy to treat a patient outside of standard care.


Basic Genetics for Donor Egg Recipients – Choosing a Donor

Lynne Gildensoph, PhD. Biology, Professor St. Catherine’s University Minnesota

The basic unit of inheritance is the Gene. A gene is a length of DNA on a chromosome that does something particular for an organism. A gene can come in more than one form. These flavors of genes are called Alleles. An allele represents one or more DNA sequences in a gene that produces a particular phenotypic result.  There isn’t necessarily a one to one mapping between mutations to the DNA sequence of a gene and different alleles for that gene. Alleles are just broad variants of a gene that can produce different results.

Genes come in two copies per individual. The different alleles of a gene may be dominant and recessive with respect to each other. It is rare that an aspect of an organism will be controlled by a single gene that has just two alleles. Heredity is seldom this simple. Most real world phenotypes are produced by complex interactions between sets of genes.

In other words, no matter how hard you may try to select a donor based on particular physical characteristics that you wish to replicate, there is no guarantee! Your baby will be your baby. You will love your baby just as he or she is.

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