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Building Your Family: ART Options at a Glance

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ART Options at a Glance

Work your way through this chart for a preliminary indication of the ART option that may be right for you.

Characteristics of the intended parents (IPs)

Sperm Donation

Egg Donation

Embryo Donation

Gestational Surrogacy

1.

I am:

  • Part of a married heterosexual couple
  • Part of a gay/lesbian couple
  • Single

Single women, lesbian couples, heterosexual couples, and gay couples who donít have viable sperm may use donor sperm.

Single women and heterosexual and lesbian couples may use donor eggs and carry the pregnancy themselves, or use a gestational carrier; single men and gay couples may use donor eggs with a carrier.

Some embryo donation programs place restrictions on recipientsí marital status, religion, and sexual orientation. Embryo donors sometimes select the recipients, and may have personal preferences.

Single parents, heterosexual couples, and gay and lesbian couples may all work with gestational carriers.

2.

I have the following financial resources to dedicate to ART:

  • Less than $15,000
  • $15,000-$50,000
  • More than $50,000

Each round of insemination with donor sperm can cost between $200 and $800; more than one round is often needed.

Total fees for a donor egg cycle, including legal and medical expenses, typically range from $15,000 to $30,000.

A frozen embryo transfer (FET) ranges from $5,000 to $10,000. If the process is called embryo "adoption," then an additional $5,000 to $8,000 for a program fee and homestudy is common.

In the U.S., costs vary widely, from little to $50,000 to $100,000 (depending on carrier's fee, program, legal, and medical expenses). In other countries, such as India, the cost ranges from $15,000 to $30,000, not including travel for the IPs.

Characteristics of the child

Sperm Donation

Egg Donation

Embryo Donation

Gestational Surrogacy

3.

The child will have a genetic link to:

  • Both heterosexual partners
  • The/A male partner
  • The/A female partner
  • Neither partner

The child will have a genetic link to the mother, or to neither parent if sperm donation was used with donor egg.

The child will have a genetic link to the father, or to neither parent if egg donation was used with donor sperm.

The child will not have a genetic link to either parent.

The child can have a genetic link to both parents, to the mother only (with donor sperm), to the father only (with donor egg), or to neither parent (with donor embryo or donor egg with donor sperm). In gestational surrogacy, the child is never genetically linked to the carrier.

4.

I understand that, with ART, there may be a higher incidence of multiple births, and that multiple pregnancies can carry significant risk.

When a woman undergoes treatment with ovulation induction medication and is inseminated, the incidence of multiple births is slightly higher than in unassisted conceptions.

The current guidelines of the American Society for Reproductive Medicine (ASRM) recommend single embryo transfers (SETs) when the egg donor is younger than 35.

ASRM guidelines recommend embryo transfer limits based on the recipientís age, prognosis, and the stage and quality of the embryos. SETs are generally recommended for women younger than 35. Some embryo donation programs prohibit multifetal pregnancy reduction.

If the eggs used to create the embryo are from an egg donor or IP who is younger than 35, and if excess embryos can be frozen, the ASRM recommends a SET. A carrier may decline to agree to a multiple embryo transfer or a multifetal pregnancy reduction. Carriers generally receive additional payment for multiple pregnancies.

The ART process

Sperm Donation

Egg Donation

Embryo Donation

Gestational Surrogacy

5.

I would like to select the donor or carrier.

Most sperm banks provide demographic, medical, and social background about the donors, and intended parents may select their donor.

Egg donation matching programs provide demographic, medical, and social background about the donors, and IPs may select their donor. The selected egg donor must be available to cycle at a certain time.

Some programs allow intended parents to select the donor embryo, some programs "match" the IPs with a donor embryo, and some programs have the donor family select the intended parents.

Most surrogacy centers provide demographic, medical, and social background about the carrier, and intended parents may select and meet their carrier.

6.

The experience of being pregnant is very important to me.

If the intended mother can carry a pregnancy to term, she can experience pregnancy and delivery.

If the intended mother can carry a pregnancy to term, she can experience pregnancy and delivery.

If the intended mother can carry a pregnancy to term, she can experience pregnancy and delivery.

A gestational carrier will carry the pregnancy to term.

7.

I donít want any additional invasive medical procedures and medications, or I would like to minimize their number.

The intended mother must monitor for ovulation, and may take ovulation-inducing medications. The intrauterine insemination (IUI) is generally quick and only mildly uncomfortable.

If the intended mother is the recipient, she must undergo screenings, then take hormones and medications to align her cycle with the donor's. The embryo transfer process is generally only mildly uncomfortable. If a frozen embryo cycle with donor eggs, the intended mother does not need to cycle with the donor.

If the intended mother is the recipient, she must undergo screenings, then take medications to prepare her uterus for the embryos. The embryo transfer process is generally only mildly uncomfortable.

If the intended mother is using her own eggs, she will need to take hormones to stimulate multiple egg production, and the egg retrieval process involves minor surgery. None of this is necessary if using donor eggs or donor embryos.

8.

I'd like the donor to be:

  • Anonymous
  • Known

Most sperm donation from banks is anonymous, although some donors may agree to some future contact with child. Also, some donors may be friends or relatives of IPs.

Intended parents may work with an anonymous or a known egg donor. There is sometimes the option to meet in person.

Intended parents may work with anonymous or known embryo donors. There is sometimes the option to meet in person.

Intended parents select and almost always meet their gestational carrier, and often remain in close contact throughout the pregnancy.

9.

I prefer the following level of continuing contact with the donor/surrogate:

  • None
  • I would like the option for contact

Donor may have agreed to future contact with child or childís parents, but not all banks offer this option, and not all donors, when offered this choice, agree.

Some donor contracts allow for future contact by the child (usually when the child is an adult), even if it is an anonymous donation.

Some donor contracts allow for future contact by the child (usually when the child is an adult), even if it is an anonymous donation.

Intended parents and the gestational carrier may or may not decide to have ongoing contact.

10.

I would like to know when we would need the help of:

  • A mental health professional
  • A legal expert

Psychological consultation is recommended, but most programs donít require it. If using donated sperm from a bank, usually no legal consult is needed. When the sperm is from a known donor, legal consultation is strongly recommended.

A psychological evaluation for the donor is required by almost all clinics. A psychological consultation is strongly recommended for IPs, and many clinics require this. A legal consultation, with independent representation for the parties, is strongly recommended, and many clinics require it.

A psychological consultation is strongly recommended for intended parents and the donors, and most clinics require this. A legal consultation, with independent representation for the parties, is strongly recommended, and many clinics require it.

A psychological consultation and an evaluation are almost universally required for the intended parents and the carrier. Legal consultation, with independent representation for the parties, is almost universally required.