An interview with Doctor Eliran Mor – IVF expert

1. An interview with Doctor EliranMor – IVF expert Doctor Mor is a fertility expert who constantly strives to stay on the cutting-edge of fertility treatments and human reproductive science. He contributes his time and expertise to help Tammuz family and we’re delighted he’s joined us for this interview.

2. Can you share your background and experience in the field of IVF and surrogacy? Background and Experience: How long have you been working with surrogacy cases, specifically for gay couples? I am a reproductive endocrinology/fertility specialist with over 20 years of experience in IVF, egg donation, and gestational surrogacy/3rd party reproduction. I have been treating same-sex gay and lesbian couples, as well as single men and women since the days of traditional surrogacy treatments (when a surrogate served as both a surrogate and an egg donor by undergoing inseminations), over 20 years ago. Process and Procedures: Can you walk us through the typical IVF and surrogacy process for intended parents? The process begins with ovarian stimulation of a female patient or egg donor (ED) and egg harvesting procedure. Sperm from an intended parent (IP) or intended parents (IPs) is used to fertilize the harvested eggs. Are there any differences in the process between gay and heterosexual couples? None, but success rates can be lower for heterosexual couples who use the female IP’s eggs, as the woman’s age determines the number and quality of eggs (and resulting embryos); whereas for gay couples using an egg donor, success rates are more or less fixed as healthy young egg donors are typically used. 2

3. Medical Considerations: What are the key medical considerations you take into account when selecting a surrogate?How does the screening process work? Many parameters are used to screen a GS prior to selecting.  These may include the surrogate’s general health status, her past obstetrical status, her uterine condition, psychological/mental health and social circumstances. How do you ensure the health and safety of both the surrogate and the baby throughout the pregnancy? Unfortunately, this cannot be guaranteed, however, with proper screening for both embryos and the GS, the chances of a positive outcome increases significantly.  A precaution which we always prefer to use is the transfer of a single embryo to the GS to minimize the risk for a multiple gestation, as twin and triplet gestations have a much higher risk of complications compared with single pregnancies. 2

4. Success Rates and Challenges What are the success rates for IVF and surrogacy procedures in your practice? In general, an embryo transfer of a euploid embryo (chromosomally normal) will result in success rates of 65-75% for a live birth.  Cumulative success rates over 2 embryo transfer procedures will climb to over 85%. What are some common challenges or complications that can arise during the IVF and surrogacy process? IVF in and of itself is a controlled process with few challenges for the ovarian stimulation and egg retrieval part.  And this is particularly true for ED cycles where outcomes are quite predictable most of the times. 2

5. Choosing Donors and Surrogates What factors should gay couples consider when choosing an egg donor and a surrogate? Gestational surrogates should preferably be of normal weight or at least not obese, preferably with a minimum of a high school education, healthy, with a history of previous healthy pregnancy/ies Support and Resources What types of support and resources do you provide for IPs throughout the surrogacy journey? We provide IPs with full support through their GS and ED journey, and as such we have a team of in-house specialist coordinators who handle the entire process on behalf of IPs:  from selecting an egg donor and ED screening, to selecting a GS and GS screening, to implementing the treatment plan all the way to embryo transfer, and then follow-up support and monitoring of the GS once pregnant. 2

6. What are the common fertility issues that heterosexual couples face, and how do you address them? Heterosexual couples may have different challenges from those faced by IPs who use ED and GS services.  These often times include infertility of long-standing duration, which may have unexplained or explained reasons.Heterosexual couples often rely on IVF as a solution, but may not always wish to rely on the proven high success treatments of ED and GS; instead we often aim to achieve success with a woman’s own eggs and often times with her own uterus as well, as well as with her partner’s sperm.  How do you determine if surrogacy is the best option for a heterosexual couple? There are various absolute medical indications for a heterosexual couple to pursue surrogacy, such congenital uterine birth defects like an absent uterus, or a unicorn ate uterus, or severe fibroid uterus or adenomyosis, or cervical factor infertility. Additionally, women who have a medical contraindication to pregnancy, such as severe cardiovascular, vascular, renal, or other medical conditions, may be good candidates for gestational surrogacy. 2

7. What advice do you have for intended parents on maintaining a positive relationship with their surrogate? The closer the relationship is between IPs and their GS the better the outcome!  IPs must be fully involved in a GS’ medical care.  Frequent communication between the IPs and GS, physically and remotely, can make a big difference in outcome.  Firstly, the GS won’t feel alone in the process and will have constant support, and secondly the IPs in this way emphasize to the GS how important she and the wellbeing of their baby are. How do you see the future of surrogacy evolving, from technical, medical, moral aspects? I believe that the social taboos around gestational surrogacy will disappear even in the most conservative societies where using a GS is currently illegal, paving the way to more and more GS services for IPs. This will make gestational surrogacy more acceptable culturally, and easier to implement technically.  From a medical scientific perspective, the phenomenon of epigenetics is an evolving field where the effect of the gestational surrogate on the upregulation and downregulation of various genes in the fetus. 2

8. Thank you again, Dr. Mor, for your invaluable contribution in helping people achieve their dream of starting a family, and we wish you many more years of blessed work. Visit Us - www.tammuz.com Phone-0737838058 2