DOCTOR MICHAEL FEINMAN IS THE MEDICAL DIRECTOR AT HRC-FERTILITY

How long has HRC-Fertility been established and where are you located? The original HRC was founded in 1988. The company re-organised and the current partnership began in 1998. My lab is located in Encino, California, with satellite offices in West Los Angeles and Westlake Village. We have two other labs and several satellites located all over Southern California. I have been working with surrogates, including those working with gay men, for over 20 years. How long have you worked in the field of fertility and what attracted you to this area? My career path in reproductive endocrinology began at the Albert Einstein College of Medicine in New York in 1986. When choosing my professional path, reproductive endocrinology was a developing field and I thought it would be exciting to be part on the ground floor of a new area of medicine. Additionally, microsurgery was an important aspect of the field and I enjoyed performing these procedures. Finally, I knew having children of my own would bring me complete happiness and I wanted to make it possible for others to share in my joy. Which services do you offer to LGBT couples or individuals wishing to start a family? We are a full-service practice that offers treatments ranging from donor inseminations to egg donor/surrogacy. I also have a long experience at helping patients with previous IVF failures. People can learn more about this at IVFImplantationFailureClinic.com Many gay couples want to create embryos from both partners and transfer an embryo from each in the hopes of generating a twin pregnancy where each man is a father. How do you feel about that? I call this “shared embryo transfer,” and, for What is the role of pre-implantation genetic screening (PGS), especially in egg donation? With PGS, we can take a small sample of cells from an embryo and determine if it has normal chromosomes. This is a useful tool to select embryos for single embryo transfer, thus reducing the risks of a multiple birth, which in turn increases the chance of a healthy outcome. Do intended parents have to travel to the US for an initial consultation? No, initial consultations can be done over the phone or through Skype. To undergo an IVF cycle, how long do patients need to be in Los Angeles? For women, if they can get early monitoring locally, they are here for just under two weeks. For men working with surrogates, they need to be here a bit less, it they intend to be present for the embryo transfer. Sometimes, men will freeze semen here in advance, to alleviate the need to be here for the egg retrieval. Why not adoption? This is an important question, especially when egg and sperm donors are used. While adoption is an alternative to infertility treatment, the simple fact is adoption may not fulfil the human instinct of creating one’s own offspring. Further, there are many legal and financial challenges with adoption that can make adoption expensive and difficult. Potential parents should look at all the options to see what is best for them. What does HRC-Fertility offer that other centres do not? The doctors and staff of HRC-Fertility have incomparable experience with “third-party parenting”, and are especially adept at working with patients from abroad. Personally, I organised one of the first anonymous egg donor programs in New York in 1987. Having multiple locations in Southern California allows us to monitor donors and surrogates closer to where they live without adding costs. Do you only perform American surrogacy? No. While my strong preference is to work with American agencies and surrogates, I also work with a reputable agency that arranges surrogacy in Mexico. Intended parents create the embryos in our lab and they are shipped to a state-of-theart clinic in Cancun for ultimate transfer. Thus, intended parents can work with me, regardless of where the surrogate mother is located. How can the process be made more efficient? When egg donors and surrogates are involved, there are occasions when the donor is ready before the surrogate mother. Intended parents should feel comfortable freezing the embryos, so they can be ready when the surrogate is available. The difference in success rates between fresh and frozen embryos is small. Also, some people working with egg donors are interested in having future genetically similar siblings. In these cases, it is also prudent to have a second cycle and freeze all the embryos for future use. I call this “Advanced Family Planning”. On a personal level, what is the greatest satisfaction you derive from your work? The greatest source of happiness and satisfaction for me has been having a family. I enjoy sharing this blessing with other people and helping them have children in a safe and ethical manner. As I said before, I have been involved with third-partyparenting for many years, and feel it is important for anyone wanting to be a parent to have all options open to them, without unfair restrictions. As a result of this experience, my focus has become the pregnancy outcome, not just the success rate.