Fertility preservation: Rachael Bland’s story

Last week, BBC presenter Rachael Bland’s fight to overcome her two-year breast cancer battle sadly came to an end. She was only 40 years old. She leaves behind her husband Steve and their young son Freddie. She also leaves behind four frozen embryos, following her battle to preserve her fertility.

Rachael shared her story on her blog Big C Little Me. She wrote compellingly about cancer and fertility saying on 19 February this year “Babies are probably not the first topic that springs to mind when you think about cancer but they were one of the first things I thought about after my diagnosis.  It’s another aspect of getting cancer that’s unique to being diagnosed when you’re young – the issue of what to do if you’ve not started or finished having a family”.

Rachael’s story will strike a chord with many women. She went to great lengths to preserve her fertility, even delaying chemotherapy to undergo an IVF cycle all over Christmas. She wrote on her blog “There are so many emotions to process when you’re first diagnosed and thinking about IVF as well might seem like a bridge too far.  But my advice would be to ask about fertility preservation, as you can give yourself some insurance pre-chemo but afterwards it might be a struggle.  You see, cancer treatment plays havoc with your fertility.  Chemotherapy targets fast-dividing cells, both the good and the bad and some of the fastest dividing are of course in your ovaries.  As a result, chemotherapy can leave you infertile and going into early menopause.  especially if you’re knocking on 40 like I was”.

Rachael’s four frozen embryos offered hope of another much wanted child had she overcome her battle with cancer. However, in undergoing IVF Rachael would also have completed consent forms at her UK fertility clinic stating her wishes for the storage and use of her embryos during her lifetime and in the event of her death. Depending upon her completion of these forms and her wishes, there might still be the possibility for her husband Steve to complete their family using these embryos in fertility treatment and surrogacy. 

As a fertility lawyer I have worked with many women over the last ten years who have been diagnosed with cancer and other serious medical conditions which have impaired or taken away their fertility and ability to carry a pregnancy. I have also worked with many women who have struggled to build a family in their late 30’s, 40’s and 50’s and seen the heartache caused by their diminishing fertility rates and unsuccessful fertility treatment cycles. As women increasingly delay starting a family into their 30’s and beyond, we need to do much more to proactively manage women’s fertility and its preservation. We need better education and more debate and awareness so women can make informed decisions and avoid crisis management.

You can read my further comment about fertility law and fertility preservation arising from Rachael’s story in my article in Female First.

Posthumous conception: a ray of hope for the future

I was proud to be part of the wife’s specialist fertility law team in the groundbreaking case of Y v A Healthcare NHS Trust & The HFEA & Z (by his litigation friend, The Official Solicitor) [2018] EWCOP 18.  In a unique legal ruling, The Court  of Protection (‘COP’) sanctioned the extraction, storage and posthumous use of the husband’s sperm following an accident and catastrophic injury.

The husband and wife had wanted to conceive a child and were in the early stages of fertility treatment, when he was involved in a tragic accident that caused a devastating brain injury. It was doubtful whether the husband had given his written consent to the storage and use of his sperm in fertility treatment in the legally required form, although he had discussed and agreed with his wife that his sperm should be used by her in fertility treatment and in the event of his death.

Only a fertility clinic licensed by the HFEA could extract and store his sperm and that could only be achieved with his effective consent.  Section 4(1A) of the Human Fertilisation and Embryology Act 1990 prohibits the procurement, testing, processing or distribution of sperm without a licence.  Very sadly, the husband’s brain injury left him without capacity to provide the required consent.

The Human Fertilisation and Embryology Authority (‘HFEA’) had no legal powers to authorise the retrieval, storage and posthumous use of the husband’s sperm in treatment in the UK.  The wife was unable to rely on the assistance of the Human Tissue Authority as sperm and eggs are specifically excluded from its remit under the Human Tissue Act 2004.  Furthermore, there was no case law which covered this situation.

Wanting to honour her husband’s wishes and family building plans, the wife applied to the COP for permission for the retrieval, storage and posthumous use of his sperm.  This was a groundbreaking move because the COP had never before been involved in a posthumous conception context.  The COP’s jurisdiction usually covers assistance with property, financial matters and decisions about personal welfare for people who lack capacity to make decisions for themselves.

The COP used powers under the Mental Health Act 2005 to reach a judgment that it was in the husband’s best interests for his sperm to be retrieved, stored and used by the wife in posthumous treatment in the UK.  The COP took into account all of the facts of the case and relied on evidence that the husband and wife had discussed and agreed his sperm should be used in fertility treatment and in the event of his death, they had been referred for fertility treatment and were under the care of a fertility clinician and had booked a further clinic appointment.

The case shines a light on the importance of taking ownership of your fertility and conception plans in the short, medium and longer term.  There are no guarantees in life and no one is immune from the risk of illness, injury, accidents or changes in personal situations which can have a fundamental impact on your or a loved one’s fertility.  Moreover, the law is complex and it does not always protect people or their future family building wishes.  Specialist fertility law advice can help you make informed decisions and proactively protect and maximise your fertility and family building arrangements.

If you would like to discuss your situation in more detail or find out more about fertility law in the UK please contact me by email lghevaert@vardags.com or by telephone +44(0)207 4049390.

Fertility and Family Law in Action

The last 12 months has been a busy year on the fertility law front. Fertility law and practice and its association with family law has continued to evolve, both nationally and internationally.

We’ve seen evolution of policy and practice around the importance of giving informed consent to fertility treatment at UK fertility clinics licensed by the Human Fertilisation and Embryology Authority (HFEA). Informed consent to fertility treatment is one of the most important principles of healthcare.  It is designed to protect fertility patients, children and others involved in fertility treatment and more needs to be done to improve understanding of the legal issues and implications of assisted conception and management of this in practice.  In September 2015, the English High Court highlighted the very real difficulties that arise when informed consent to fertility treatment falls short, which left eight couples embroiled in legal parenthood proceedings following fertility treatment and the birth of their children and highlighted a further 75 similar cases.

We’ve also seen continued debate about surrogacy law and practice. My work as a member of the Surrogacy UK Working Group on Surrogacy Law Reform and the publication of its report Myth Busting and Reform in November 2015 sheds valuable light on the current practice of surrogacy in the UK and sets out recommendations for reform.

UK industry recognition for fertility and family law is to be welcomed. I was delighted to be awarded recognition by Chambers & Partners UK 2016. This helps raise awareness and promote the importance of fertility law in the UK.  Assisted conception can raise many complex legal and practical issues in the context of increasingly challenging family building expectations and demands of modern day living.  Assisted conception can be daunting and fertility law is not always ‘a good fit’ in practice. The provision of skilled fertility law advice helps place children born through assisted conception and their families on a secure legal footing and provides valuable support and protection if problems arise.

Fertility, parenting and family law issues have continued to feature in the media. Over the last 12 months I have contributed to public debate and provided legal commentary on BBC World Service radio and BBC Radio London, as well as in the Independent, the Guardian, the Times and legal and fertility sector press. I have also lectured on fertility, parenting and family law issues in the UK and delivered a lecture overseas in Chicago, USA, at the American Academy of Assisted Reproductive Technology Attorneys Fall Conference 2015.

I can be contacted by email lghevaert@vardags.com or by telephone +44 (0)207 4049390.

 

 

 

Elizabeth Banks welcomes second surrogate son

Hollywood actress, Elizabeth Banks, 38, has hit the headlines again this week following the announcement of the birth of her second surrogate born son.

Baby Magnus joined older surrogate born brother Felix, aged 20 months, at her home earlier this week.  Elizabeth said “As 2012 winds down and Thanksgiving approaches, I have much for which to be thankful – personal, professional and Presidential.  However, nothing can match the joy and excitement my husband and I felt when we recently welcomed our second baby boy, Magnus Mitchell Handelman.  Like Felix, Magnus was born via a gestational surrogate. This experience has exceeded all expectations, taught us a great deal about generosity and gratitude, and established a relationship that will last a lifetime.”

Elizabeth captured the hearts of many following her honest account of her own battle with infertility and her and her husband’s decision to turn to surrogacy for the birth of their first son, Felix.  Elizabeth quickly became a role model for those looking to build families of their own through surrogacy with her sensitive approach to infertility and her decision to speak so openly and honestly about her own journey to parenthood through surrogacy.

Earlier this week, Elizabeth went on to say “I am also so very thankful to our family and friends for their support throughout this process, as well as the Center for Surrogate Parenting for helping make all this possible.  I now turn my attention to managing two boys under two. For which I am thankful.  And all their poop. For which I am less thankful. Wish me luck”.

Celebrity endorsement of surrogacy by people like Elizabeth continues to help raise the profile of surrogacy.  Elizabeth has publicly given an honest and positive experience of the process and the joy it has brought to her and those around her.  Her story helps to give hope to others battling infertility and shows that surrogacy can deliver the life-changing gift of a child.

If you would like to discuss your situation in more detail or you would like more information about the legalities of  UK surrogacy law please contact me by email lghevaert@vardags.com.

Fertility and Parenting law team shortlisted for The Law Society’s 2012 Excellence Award in Innovation

I am delighted that my team and  have been shortlisted for the Law Society’s 2012 Excellence Award in Innovation.

This recognizes our cutting-edge, pioneering and innovative legal work helping people all over the world build families through fertility treatment, international and UK surrogacy, donor conception including known donation and co-parenting, as well as our work concerning family, children and parenting disputes.

The Law Society’s prestigious awards ceremony recognizes excellence across the legal profession and outstanding contributions from solicitors and their teams.  Winners will be announced at a black tie event on 18 October at Old Billingsgate, London.

 

The legacy of Jill Hawkins, the UK’s most prolific surrogate mother

Jill Hawkins announced this week that she plans to retire from her role as a surrogate mother in the UK.   Jill, a 48 year old legal secretary from Sussex, has given birth to ten surrogate babies and given unimaginable joy to the childless couples she has helped over the last twenty years.

Jill’s legacy puts surrogacy in the spotlight again, at a time when there has never been greater debate about the the practice of surrogacy around the world.  There continues to be strong demand for surrogacy and Jill’s commitment and dedication, as the UK’s most prolific surrogate mother, gives real and meaningful insight into the practice.  Her views stand as clear affirmation of the positive benefits surrogacy can bring to both surrogate mothers and childless couples alike and her views paint an altogether different picture from much of the recent negative coverage, particularly of Indian surrogacy which has once again raised concerns about exploitation, ‘baby buying’ and organized  ‘baby farms’.

In an interview with The Telegraph this week, Jill said “I love doing this.  I meet amazing couples who are heartbroken and I want to make them happy.  It will be hard to walk away”.  Interestingly, she says of foreign commercial surrogacy “I can understand why most women in this county might find the idea of an organized baby farm abhorrent.  But I don’t have a problem with it.  These women are host surrogates, they aren’t using their own eggs.  I know from personal experience that it’s perfectly possible to detach yourself and not feel as though it’s your baby”.

She said of her own motivations, “It’s hard for someone who really longs for a baby to understand that I don’t, but this whole journey began because I personally wanted to experience pregnancy, not be a mother”.  She also tellingly and poignantly said “People talk about the gift of life, but surrogacy has saved mine so many times. It has given me purpose, a vocation that brings happiness.  I become part of a couple’s life and, if I’m honest, it’s been a way of distancing myself from my own life, my own problems. The newspapers called me a baby factory and said I got depressed because I gave up my babies.  But they weren’t mine – having them was the best thing I’ve ever done”.

As a lawyer who practices in the field of fertility, parenting and surrogacy law, I often get asked about the reasons why a woman would want to offer herself as a surrogate mother and carry a pregnancy for someone else.  Many intended parents worry that a surrogate mother will change her mind and want to keep the baby and the fact that surrogacy agreements are not enforceable in law in the UK as a matter of public policy.  Those battling infertility are often understandably concerned that their longed for and much-wanted baby might not end up in their care and that they might somehow be held to ransom by a surrogate mother, with little or no legal rights of their own.  Jill’s legacy and views stand as testament that many surrogate mothers want to help someone else achieve their dream of parenthood, and that they are motivated by a personal enjoyment of pregnancy and a strong sense of altruism.

I met Jill in person, when we were both interviewed on BBC Breakfast TV in January 2011.  Jill was forthright, upfront and eloquent about her experience and role as a surrogate mother in the UK.  She was proud of her contribution and legacy and her passion and dedication as a surrogate mother was palpable.  Jill’s experience shows that surrogacy is not a one-way street that favours intended parents and exploits surrogate mothers. Jill’s experience shows that surrogacy is a complex, rewarding and deeply personal experience that creates a life-changing legacy in the form of a baby.  It brings joy, a much wanted-baby and a sense or purpose.  It also gives childless couples the opportunity to have a genetic child of their own.

That said, surrogacy can raise complex legal issues and problems, particularly in cases of foreign surrogacy and on occasions when domestic surrogacy agreements  breakdown.  English law dictates that the surrogate mother is always the child’s legal mother at birth and her consent and co-operation is required for intended parents to obtain full legal parental status for the child by way of a parental order.  A surrogate mother is therefore at the heart of the process in every sense.

If you would like to discuss your situation in more detail or you would like more information about the legal issues surrounding surrogacy please contact me by email lghevaert@vardags.com.

Surrogacy ban to hit Queensland: a worrying step backwards

The Queensland government has announced that it plans to change surrogacy law to prevent single people, gay couples and straight couples who have lived together for less than two years from undergoing surrogacy. Existing altruistic surrogacy legislation was only passed in February 2010, de-criminalising altruistic surrogacy although commercial surrogacy remains a crime.

The Queensland Premier Campbell Newman said shortly before his election in March that his party would not make any changes to surrogacy law.  He has subsequently said this was a mistake and that they intend to change the law and restrict surrogacy to longstanding heterosexual couples only.  These proposed changes will effectively criminalise altruistic surrogacy arrangements for single people, gay couples and heterosexual couples who have lived together for less than two years and they will face a prison sentence of up to three years if they have a child through surrogacy.

These proposed changes represent a significant government u-turn and a worrying step backwards in terms of the rights of single people and gay and straight couples to access surrogacy.  These proposed changes will create additional worry and heartache for many prospective parents, who will either seek to keep ‘below the radar’ with their family building plans or move to a state with less restrictive and discriminatory laws. Interest in surrogacy continues to grow around the world.  Growing numbers of intended parents are already crossing borders to access surrogacy in the face of restrictive laws at home and these numbers look set to increase in light of these proposed changes to the law in Queensland.

Surrogacy arrangements, particularly those with an international element, can raise complex legal issues and international conflicts of law. If you would like to discuss your situation in more detail or you would like more information about the legal issues associated with international surrogacy please email me lghevaert@vardags.com.

Louise Brown, the world’s first IVF baby, talks about surrogacy and assisted conception

Louise Brown (aged 33) was the first baby to be born through IVF.  Louise’s mother, Lesley, pioneered the practice of IVF in the UK (and around the world) and she sadly  died recently after developing septicaemia whilst being treated in hospital for gallstones. Louise and her mother were very close and Louise paid tribute to her mother in a recent media interview saying “She gave me life – and every woman the chance to be a mother” and “I don’t think I could have tried for a baby for as long as she did.  I’d have given up, but she never did”.

Louise, herself now a mother, endorses IVF treatment although she admits to worrying about the consequences of scientific developments  in assisted conception.  She recently said during a media interview “IVF has helped millions of couples have babies.  Of course I’d have had it myself if I’d needed to”. She went on to say “I’m happy for same-sex couples to use IVF to have a baby, but I don’t believe couples should be able to choose the sex or anything else for their child unless it’s for medical reasons”.

In terms of surrogacy, Louise said “I don’t have strong feelings about surrogacy – if it’s used properly it can help women who can’t carry a child.  Her biggest concern, however,  centres on the rising numbers of older women seeking assisted conception to become mothers.  More and more women are turning to IVF and surrogacy to have a much wanted child when their attempts to conceive naturally prove unsuccessful, often later in life after they have established their financial positions, personal lives and careers.  IVF can be very gruelling and surrogacy is not for the faint-hearted given the UK legal restrictions and the complex legal and logistical issues associated with international surrogacy arrangements. Louise acknowledges this growing trend but said “Children need their parents to be there, so I believe in having children young, to see as much of their lives as possible” and “I can understand why some older women might be desperate for a family if they haven’t had one, but I’d be worried about women in their fifties having a baby just because they can”.

The desire to have a baby can be incredibly powerful and deep seated and these feelings can drive people of all ages and walks of life to want to have a child.  In the knowledge that assisted conception, IVF and surrogacy is a global reality and that scientific developments are improving pregnancy success rates all the time, increasing numbers of people are choosing to become parents later in life and build non traditional family structures (including solo parents, co-parenting and known donor arrangements). This brings with it all manner of additional challenges, both legally and practically.

If you would like to discuss your situation in more detail or you would like more information about the legal issues surrounding surrogacy, IVF, donor conception, known donation, co-parenting arrangements or becoming a solo parent please email me lghevaert@vardags.com.

International surrogacy in India: an unregulated market

The unregulated Indian surrogacy market could be worth as much as £1.5 billion a year and growing, according to Indian authorities.  It is believed there are up to 1,000 Indian clinics offering surrogacy and fertility treatment services to international intended parents through a combination of IVF, egg donation and surrogacy.

Demand for surrogacy in India continues to rise, with increasing numbers of British people travelling to India to have a much wanted baby in light of the legal restrictions and perceived uncertainty associated with the process in the UK.  British intended parents willing to travel to India for surrogacy come from all walks of life and include both  heterosexual and same-sex couples.  Many have turned to surrogacy having become concerned about the difficult and complex procedure to adopt and foster in the UK.

The Indian government has carried out a study looking at ways to introduce legislation to regulate surrogacy in India.  Proposals have been drawn up to introduce safety standards, prohibit sex selection, prevent women able to carry their own pregnancy from undertaking surrogacy and establish a register of clinics with a regulatory body to supervise and enforce standards. The  proposals would also require intended parents to be able to confer their own citizenship upon their surrogate born baby automatically at birth in an attempt to prevent further cases of babies being born stateless and parentless due to an international conflict of law. However, legislation remains in draft and it could take many years before it becomes law.

For those experiencing infertility or same-sex couples, surrogacy can deliver hope and a much wanted child.  However, international surrogacy is fraught with complex legal issues and potential pitfalls.  There is a public policy ban against commercial surrogacy in the UK and egg donors can only be paid £750 for expenses and this causes an international conflict of law when British intended parents enter into a commercial surrogacy arrangement and conceive with the help of a commercial egg donor in India.  Law in the UK does not automatically recognise an Indian birth certificate naming intended parents as their surrogate born baby’s parents and they currently need to undertake a complex parental order application in the English court to secure parental rights in the UK.  Intended parents must also have a viable immigration action plan to ensure they can obtain the right travel papers and clearance to get their baby home safely to the UK after the birth.  In the absence of this, they risk their baby being left marooned abroad and facing a difficult and complex legal battle with the British Home Office.

If you would like to discuss your situation in more detail or you would like more information about the legal issues associated with international surrogacy please email me lghevaert@vardags.com.

Surrogacy and donor conception: the question of parenthood

Advances in fertility treatment have outstripped the law and this increasingly challenges traditional concepts of parenthood.  For those who have struggled for years with infertility or never thought they could have a child, they can now conceive using a sperm donor, an egg donor, a surrogate (or a combination of these).  This creates a key question: who is a parent?

Traditionally, parenthood followed biology.  The woman who gave birth to the child was legal mother and her husband was the presumed legal father.  However, it is now a far more complex question in assisted conception cases.  As growing numbers of people embrace fertility treatment, cross borders, engage foreign surrogacy organizations and conceive with donor eggs and sperm the concept of parenthood can seem confusing and unclear. This challenges existing law and policy and has resulted in a a legal jigsaw puzzle that many struggle to make sense of.

Assisted reproduction and modern family structures challenge traditional notions of family.  Increasing numbers of people are creating families through surrogacy, using a known donor who may have ongoing involvement with the family, through co-parenting arrangements or embracing family life as a solo parent.  This raises questions about the legal status and role of the individuals involved and whether parenthood should be based on biology, intent, pregnancy and birth or social parenting.

The structures of modern families are changing and assisted reproductive technology is developing at a fast pace.  The law has not kept pace with these developments and there needs to be greater understanding of the different pieces of the jigsaw that make up family building through assisted conception, sperm and egg donation and surrogacy.  Only then, can we effectively tackle the question of parenthood and put effective law and policy in place.

If you would like to discuss your personal situation in more detail or you would like more information please email me lghevaert@vardags.com.