Dr. W.A. Krotoski’s missive of May 17 in the editorial section of The Advocate prompts a response from me.
As a board-certified specialist in both obstetrics/gynecology and reproductive endocrinology/infertility whose medical practice is devoted to bringing children into the most-wanted homes on the planet, I must take issue with Dr. Krotoski’s understanding of gestational surrogacy. No one knowledgeable in the area would consider this option except in the most complex of circumstances including physicians, embryologists and patients.
Medical indications, either anatomical or physiologic, must exist making it impossible or life-threatening for the genetic mother to become pregnant. Physical, medical and psychological screening is performed on all patients (including the potential surrogate), thus eliminating the risk of “doubling the potential genetic incompatibilities” referenced by Dr. Krotoski.
Pregnancy is a dangerous medical condition that no participant takes lightly. Informed consent and subsequent patient education insures that all involved have a complete understanding of the entire procedure.
Finally, the last of the missive that deserves comment involves embryos created by in vitro fertilization.
Dr. Krotoski knows that Louisiana law protects all embryos outside the uterus. Once in the uterus, they are under federal law and do not have the same protection. Frozen embryos are thus still protected by Louisiana state law. Every fertilized egg is given the opportunity to create a life. They are either transferred to the uterus or cryopreserved for transfer at a later date.
In today’s IVF world in the United States, a maximum of two embryos are transferred (genetic mother or surrogate) when the genetic mother is 40 years old or younger. Only under special and unique circumstances may more that two embryos be transferred under the guidelines prepared by The American Society of Reproductive Medicine and the Centers for Disease Control in Atlanta.
In this desperate and heart-wrenching circumstance, support should be given to this very personal decision made in an attempt to bring one’s own genetic child into the most wanted and desired of environments.
Bobby W. Webster, medical/practice director
A Woman’s Center for Reproductive Medicine