Download:

Confidential Application
Medical Evaluation Sheet

All applications will be reviewed during the months of
May 1, 2010 through July 31, 2010

Selection is based on the compelling nature of an applicant's circumstances, their fertility history, financial situation and a number of other determining factors. While consideration will be given to those who already have one child, preference will be given to those with no children.

All applicants must meet the following basic criteria:

1. Must meet the Definition of Infertility as defined by the American Society for Reproductive Medicine Definite of Infertility.

(a) Infertility is defined by the failure to achieve pregnancy after 12 months or more of regular unprotected intercourse.

(b) Earlier evaluation and treatment may be justified based on medical history and physical findings and is warranted after 6 months for women over the age of 35 years.

(c) Recurrent pregnancy loss is defined by two or more failed pregnancies. After three or more losses, a thorough examination is warranted.

2. ART (Assisted Reproductive Technology) candidates who will be using their own eggs should be "under 44 years of age and should have:

(a) No evidence of premature menopause;

(b) At least one accessible ovary; and

(c)  A normal uterus.

Menopause and ovarian function are irrelevant for candidates using donor eggs. Donor egg recipients should be under 50 years of age and have a normal uterus." (http://www.sart.org/Guide_ARTCandidates.html)

3. Must demonstrate overall good physical and mental health and have no medical conditions that would pose a serious health
risk to themselves or the child they would carry (e.g., active acute infections).

4. Must maintain adequate living arrangements (must lease or own a residence).

5. Must possess means to offer continuing child support (at least one partner must maintain employment).

6. Must have basic health insurance for mother and baby with sufficient prenatal coverage.