There’s much to celebrate in New York! After years of fighting to end the ban of compensated surrogacy and legal reform for the surrogacy process, the new law, effective February 15, 2021, makes dreams of a family a reality for New Yorkers! Not only is this great news for intended parents in New York, it’s also monumental for women who want to be gestational carriers to help these families. They can now become surrogates with some of the strongest protections available in the United States.
All Things Conceivable Podcast: Dr. James Grifo in conversation with Nazca Fontes
Nazca Fontes, founder of ConceiveAbilities and host of the All Things Conceivable: A Surrogacy Podcast talked with our partner, pioneering fertility expert Dr. James Grifo, director of NYU Langone Fertility Center, who shared his perspective on what the law means for New York, why it needed to change, and why he loves practicing in NYC.
NF: How did you become interested in specializing in fertility?
“I've been practicing in the fertility field for about 35 years. When I did my rotation in obstetrics and gynecology as a medical student at Case Western Reserve, it became clear this was a field that was right for someone like me. My main goal was to use science to make IVF safer and better. Since then, we've developed a lot of new tools and techniques that have dramatically changed the way we practice, which is very relevant for the gestational carrier setting, because getting your gestational carrier pregnant with an embryo that either doesn't make her pregnant or has a higher chance of making a miscarriage is a problem. We now have tools where we can select embryos, put back a single embryo, have a much lower miscarriage risk and have a much better chance of a good outcome. And that's good for everybody.”
NF: When it comes to surrogacy in New York, what makes New Yorkers great partners in their surrogacy journey?
“The best part about practicing in New York is, is the patients. New York patients are very educated and very savvy. They're just amazing. They're diverse: they are single men and women, lesbian couples, gay couples, and heterosexual couples. We help people build families and it's great because loved and wanted children are the secret sauce to a better world.”
NF: Why did the New York laws lag so far behind the rest of the country?
“The original case that led to the New York law was Mary Beth Whitehead. She carried a pregnancy, which came from her egg. She was inseminated with the husband of the couple that was going to get the baby. In the midst of pregnancy, she changed her mind and it became this awful litigation. I think the litigators at the time, not knowing where the future was going, passed a very restrictive law that basically outlawed someone like me and criminalized helping a patient have a family through a gestational carrier. What they didn't anticipate in the law was that there would come a day where we could take eggs and embryos and make embryos from a couple or an individual and put genetic material in a gestational carrier that would not have any genetic relationship to her. So that's where the term gestational carrier is a more precise term because it implies that this embryo has nothing to do with the carrier. She's basically carrying a pregnancy for someone else, not related to her, so they can have a baby they otherwise wouldn’t be able to. The legislation that was passed prevented us from helping that couple or the woman who didn't have a uterus because she had a hysterectomy but had embryos or the woman who was born without a uterus or the gay couple where there is no uterus. It basically cut them out of building families and what wasn't the intent of the law. The intent of the law was to avoid a situation where someone changed their mind in the middle, but that doesn't happen with the way a gestational carrier has been done for many, many years. It's a tragedy that it took this long, but thankfully it's happening.”
NF: Before the law passed, what did it mean for New Yorkers seeking surrogacy to build their families?
“We had a patient in New York who couldn’t carry her own child. Her sister-in-law volunteered to be an altruistic carrier but we were terrified because we were subject to being criminals. Doing the transfer in New York at the time, as a doctor, you put your whole career on your line trying to help a patient. We know what our intent is. To think that someone out there wanted to put us in jail for that really is not a good feeling when you know what you're doing is absolutely right. Mainly what we did was we would make embryos here. We would ship embryos to the place where the carrier would be in another state where the laws were more friendly, like New Jersey, Connecticut, or California. It added an excessive expense and burden to the patient. It also meant they had to be far distanced from their carrier. Then you have a law that makes it even more costly for no good reason-- that's really adding insult to injury. Thankfully now it will be okay”
NF: How will the new law impact the lives of New Yorkers going through surrogacy journeys?
“It allows them to do it here in New York. They don't have to travel and add extra cost, burden and complexity to an already complex process. It respects them as people who want to have children and they should get that respect and family building opportunity. It's a big breakthrough for our New York patients and also for women in New York who want to be a gestational carrier because that is an amazing job that someone does. They feel like they have made a huge difference in the world by giving that gift to a couple or an individual who wants to raise a child who couldn't otherwise carry that child. The ability to give that gift is very special and taking that away from them has been a tragedy.”
NF: In your experience, what motivates a woman to be a gestational carrier?
“They know what a gift and a privilege it is to have a child and they can only imagine what it's like for somebody who can't have that gift. They take their job of giving that family a gift incredibly seriously. If you're someone who's using a gestational carrier and you're smart about how you manage your care, you have to treat them like they are doing the most important job in the world for you. When that happens, it's always a win-win situation. The carrier feels great about what they've done and the family who gets a baby, who would not have had a baby, understands what a gift and a privilege that is.”
NF: How is NYU Langone Fertility Center ready to serve New Yorkers choosing surrogacy?
“We're looking at the way other surrogacy professionals have worked with gestational carriers in America and trying to take the best of everything and build our process. We know the embryo side of it, that's what we've been doing for years. Now, we will actually be managing the carriers, helping them get pregnant, and making sure they get optimal care. We have to do everything we can to assure that this gestational carrier will have a safe, good outcome. There's a whole team involved in making this process happen. Working with the agencies is fun because we know we can help a whole new group of patients be a part of the surrogacy process.”
NF: What has been the biggest aha moment in the surrogacy field throughout your career?
“I think the most critical aha moment for this field is single embryo transfer. Being able to put back chromosomally normal embryos leads to such better outcomes. Even a young egg donor, half the embryos that make it to day five are chromosomally abnormal. If we're just looking instead of testing and they don't make pregnancies or they make miscarriages. So you have a carrier who's going to be carrying an embryo that makes a miscarriage, it's an awful experience for the carrier. They feel like they've failed and it's not them. It's the embryo and to have the patient’s joy of pregnancy taken away from them at that earliest stage is devastating. So the aha moment for me is when we could biopsy an embryo and select the one that's chromosomally healthy and that is going to give a good outcome.”