Sam Everingham Director Growing Families
Surrogacy & Egg Donor Journeys amidst Travel Restrictions
January 2021 Are clinics even open for IVF & surrogacy?
We need an egg donor, but cant travel to provide sperm, Can we ship sperm across borders?
I have Donor Embryos Stuck Overseas Can I bring them home? Can I travel for embryo transfer?
January 2021 I have embryos in my home state, but need a surrogate Can I ship them for surrogacy?
I don’t have embryos ready, Can I make them at home and ship overseas?
What are the costs and timelines?
January 2021 Are OS destinations open for IVF/Surrogacy?
Surrogacy Open Ease of shipping Destinations IVF Destinations US √ More complex for sperm South Africa √ Canada √ More complex for sperm Spain √ Colombia √ straightforward
Georgia X
Greece √ More complex
Ukraine √ Significant paperwork
Mexico √ Expensive
Cyprus √ More complex
Albania √ unknown
January 2021 Can overseas donors still travel to Australia?
No
Can I ship eggs?
Yes, but thaw rates are not so good Better to ship embryos or sperm
January 2021 I have Donor Embryos Stuck Overseas
January 2021 Our embryos are in the US/ Greece/ Spain/ South Africa….
Can we ship the embryos back to Australia?
Australian IVF clinics wont accept embryos unless
• Donor is identity release/known (No flexibility here) • Donor was altruistic • Donor has had counselling offered
If in Victoria, your application needs to go to VARTA board meeting In other states at the discretion of each IVF clinic
January 2021 Our embryos are in the US/ Greece/ Spain/ South Africa….
Can I travel overseas or interstate to have an embryo transfer?
Yes Growing Families has assisted >15 intended mums to travel in the last 3 months to US, Spain, Greece or South Africa
January 2021 Our embryos are in the US/ Greece/ Spain/ South Africa….
Can my partner accompany me?
Yes, or your mother or other relative
January 2021 Travelling for Embryo Transfers….
What proportion of travel exemptions approved?
40% if you apply directly
Growing Families has a professional fast-track service for these (100% are approved)
January 2021 Travelling for Embryo Transfers….
Travel Exemption Application Growing Families can $300 advise what supporting documents required Advise what your medical letter needs to say to fit your circumstances Collate and review these Upload on your behalf and fast track approval
January 2021 Making Embryos/ Freezing Sperm for Cross- border Surrogacy
January 2021 How can I start cross-border surrogacy if I cant travel to my surrogate’s country/ state?
Create Embryos in home city and ship
OR
Collect, test and freeze sperm for shipping to use in egg donor surrogacy
January 2021 How do I sign contracts/meet surrogate etc?
Contracts can be emailed, printed, signed, and mailed back
Surrogate and Egg donor selection and matching can occur remotely
January 2021 Sperm Collection Steps – for USA
We will send you to a specific IVF Professional in Syd/ Mel/ Bris who understands US protocols
Patients reviewed by Doctor (History & Physical Exam)
Preliminary semen analysis & blood tests
FDA test kits couriered by US IVF clinic to patient. Stored
Patient put in touch with Path lab to schedule blood, urine and semen collection (Monday)
Patient comes in for blood, urine, semen. Completes FDA questionnaire separately
January 2021 Sperm Collection Steps – for USA
Lab conducts Sperm analysis & freezes samples
Lab sends patient blood/urine samples to US IVF clinic by return Fedex bag
Blood/urine samples tested & cleared by FDA
Frozen sperm samples shipped to recipient US IVF clinic
January 2021 Collection Steps - Canada
1. Engage with Canadian clinic 2. Sperm analysis, blood tests and physical exam 3. request testing kit 4. Receive kit and view instructions and video 5. Get GP referral for blood tests 6. Deposit sperm (within 48 hours of kit receipt) 7. Courier to collect both & send back
January 2021 Collection Steps – Ukraine
We will send you to a specific IVF Professional willing to assist
Patients reviewed by Doctor (History & Physical Exam)
Patient put in touch with Path lab to schedule tests
Patient comes in for blood, semen collection
Tested for HIV, HbsAg -Hepatitis B, VDRL- Syphilis, Hepatitis C
January 2021 Paperwork Steps - Ukraine
Results emailed to receiving clinic on sending clinic letterhead
Apostilled Marriage Certificate & Passport
Letter from treating physician indicating reason for surrogacy
Signed, apostilled Power of Attorney
January 2021 Clinic Certification
January 2021 For Ukraine/Georgia, many documents need to be notarised then apostilled
Name Contact City Suburb
John Pearce www.notarypublicmelbourne.com Melbourne Jagdeep Jassar 9225 7444 [email protected] Melbourne CBD Owen Harris 0419 212579 Canberra Melissa Lammers 02 9526 3444 Sydney Miranda Katrina Haddad www.prestigesolicitors.com.au 02 9637 5011 Sydney Merrylands
S Moran & Co [email protected] (02) 9954 0066 Sydney Milsons Point
Charles Appleton [email protected] 0412 229 139 Sydney Naremburn
Guy Gibbons Bennett Carroll Solicitors 1300334566 Brisbane Mt Gravatt
January 2021 Apostille Example
January 2021 Apostille Process
January 2021 Australian Lab costs
Blood/Urine collection $20 Semen Analysis $154 (Medicare rebate of $51)
Sperm freeze $310
Transport admin fee $300
Sperm storage –pro-rata fee $50 per month for first 3 months - then $250 per 6 months
January 2021 Shipping
January 2021 Two Shipping Options
Hand Carry Temperature-controlled Freight
January 2021 Shipping Embryos which used donor eggs
If you used a known donor, cant send to Ukraine
Ex Australia • If in Victoria, you cannot ship without VARTA approval
Into Australia • Donor needs to be altruistic, identified and have received counselling
January 2021 Current Hand Carry Options
International Domestic
Pam Matthews
Cryozoom Complicated paperwork to cross state borders, but doable
• Infrequent ability to reach Aust • Limited flights • Limited to quarantine hotel
January 2021 Quarantine hotel
January 2021 Sensitive Freight Shipping
• US-based, but • US-based • US/UK-based • Australian Australian branch • Specialise in Colombia • Embryos/Sperm • Pick up from • Sperm only • Offer insurance • Shared shipments multiple locations • Shared shipments • Shared shipments • Pick up from multiple • Pick up from two locations • Pick up from just one locations location
• Australian • Poor shipper availability • Specialise in domestic
January 2021 Clinic Release Form
January 2021 Risks & Mitigation
Shipper being lost in transit • Hand carry prevents this • Minimising transit points reduces this
Sperm/Embryo thaw in transit (failed freeze) • A risk if cryoshipper tips over in cargo
• Temperature tracking documents this
• Modern cryoshippers built to avoid this
• Insurance available (Cryoport only)
January 2021 Risks & Mitigation
Flight Delays • We wont ship until destination country has stable freight • avoid multi-stop trips • Shippers designed to allow additional days in transit
• Depending on size, Cryoshippers maintain freeze 9-21 days
• Shippers can be ‘topped up’ at interim clinics
January 2021 Risks & Mitigation
ISSUE EFFECT SOLUTIONS • More reliance on freight options Lack of Flights Courier may be stuck overseas for weeks • Select UK-based couriers can do hand- Two weeks Quarantine Unviable for AU-based carry pick up required into AU couriers to operate • Our domestic courier (Pam Matthews) Quotas on incoming delivers interstate embryos to passenger arrivals international courier in hotel quarantine
January 2021 Timelines
• Hand-carry available every 8 weeks to Ukraine or US
• Sensitive freight available on demand to most destinations (likely 2 week wait)
• Paperwork • Requires 2-3 weeks prep time
January 2021 What can insurance cover?
warming events during transit
What is the cost? Single Shipment • $150 covers for up to $25,000 • $250 covers for up to $50,000
Multiple Shipment in one shipper • $215 covers for up to $25,000 • $380 covers for up to $50,000
January 2021 Shipping Costs (AUD) – per shipment
To LA $5 800
To Ukraine $7 400 Shipping costs reduced significantly if we can put you in a shared shipment To Georgia $6 400
To Greece $5 000
To Canada $7 300
To Colombia $6 500
January 2021 Arrange Myself or Outsource?
World Couriers (Sperm) needs to be via Growing Families
Cryoport (Embryos) you can deal with direct for solo shipments https://mycryostork.com/contact-us/ register with Growing Families if prefer shared shipment
Hand-carry shippers: Register with Growing Families for shared shipments
January 2021 Person 1 Person 2 Name Inclusions Embryo & Sperm shipping support Contact Details Street Address State/Territory Country Email address Phone IVF Clinics Have you prepared Blood test results documentation your receiving clinic requires? Embryology report
Other paperwork Embryos (number _____) Sperm _____ (number of straws) Earliest date ready to ship? Pick up address of sending clinics Address of Receiving clinic Email contact receiving clinic Phone contact receiving clinic
January 2021 Summary for those Commencing
1. Understand costs & processes
2. Decide on a receiving IVF clinic/agency (or ask us)
3. Obtain our assistance in managing the paperwork
4. Complete Journey Support
January 2021 Locating Egg/Sperm Donor
30 mins face-to-face or online consultation • Understand your needs, communication preferences and priorities
• Explain domestic and/or international egg donor processes & costs end-to- $190 end, differences by location, legal, counselling and medical considerations • Provision of domestic and international egg donor options • 30 mins follow up support
January 2021 Initial Consult & Support
60 mins face-to-face or online consultation • Understand your needs, budget, timelines, medical issues, communication preferences and priorities $440 • Explain domestic and/or international egg donor and/or surrogacy processes & costs end-to-end, risk factors, differences by location, legal and medical considerations. • One hour follow up support
January 2021 Provider Selection & Enrolment
• Introduction to suitable pre-qualified donor providers, surrogacy agencies, IVF clinics, lawyers, and other relevant professionals • Co-ordination of paperwork for program enrolment $500 • One hour in depth email & telephone support and information provision
January 2021 Journey Support
Twelve months of phone & email support (up to 10 hours) seven days a week $2100 8.30am – 6.00pm • Review documents • advise on key decisions • provide introductions to families • Problem-solving & crisis support • provide Logistical and money transfer support • update you on changes to entry/ exit requirements and programs
January 2021