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Surrogacy & Egg Donor Journeys Amidst Travel Restrictions

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Surrogacy & Egg Donor Journeys Amidst Travel Restrictions 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
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