61yo is surrogate mother for son, his husband

by NCN Health And Science Team Posted on April 2nd, 2019

Omaha, Nebraska: Cecile Eledge, a 61-year-old Nebraska woman who served as a surrogate mother for her son and his husband has given birth to a baby girl.

Matthew Eledge and Elliot Dougherty were talking about becoming parents when Eledge’s mother and Dougherty’s sister offered to help.

Cecile Eledge was 60 at the time and had gone through menopause, but she was approved as a surrogate after extensive screening. Dougherty’s sister was the egg donor, and after doctors used Eledge’s sperm to fertilize the egg, the embryo was implanted.

Cecile Eledge gave birth last week at Nebraska Medical Center in Omaha. The family says they’ve received nothing but support.

Dr. Ramzy Nakad is a maternal-fetal medicine specialist who worked with the family. Nakad said that doctors keep older expectant mothers under heightened surveillance, and in this case, “everything was aligned for a good outcome.”

When Matthew Eledge and husband Elliot Dougherty started talking about starting a family, Matthew’s mom chimed in with an offer.

“I just said, ‘Oh, wow, if you ever need a carrier …. I enjoyed being pregnant, I’d do it in a heartbeat,’ ” Cecile “Cele” Eledge recalled.

Later, Matthew mentioned the offer to the couple’s fertility specialist in Omaha.

Not that Matthew was really serious. Cele was 60 at the time, a good 10 years past menopause. Could such a thing even work?

It could, although only for a rare few who were fit and healthy, like Cele. And it would take young eggs — in their case, donated by Elliot’s sister, a young, married, mother of two — and implanted through in vitro fertilization. Elliot’s sister would be the biological mother; Matthew would be the biological father.

And it did work.

On Monday, Cele, now 61, delivered her healthy granddaughter, Uma, at the Nebraska Medical Center.

Matthew said the Omaha couple plan to explain it to their daughter in terms she can understand: that her grandmother furnished the garden where she grew, and that her aunt, Lea Yribe, generously supplied the seeds.

Matthew said people have had questions along the way. Once they explain, people understand. The family has received nothing but support.

“We all seek connection, and we seek love and support,” he said. “At the end of the day, that’s all we’re doing.”

Matthew and Elliot married in fall 2015. It was seeing two of their siblings have kids that sparked the conversation about building a family.

They considered adoption but weren’t sure how the process worked for gay couples. They wanted more control over the process, so they decided on in vitro fertilization, an increasingly common method both for same-sex couples and couples who struggle with infertility.

They knew they’d need eggs and a woman to carry the baby, also known as a gestational carrier.

In stepped Yribe, now 26. “When they first mentioned wanting to take this step and have a kid, I told them I would want to do whatever I could to help them,” she said.

By the time they were ready, she’d recently delivered her second child, so carrying another so soon wasn’t a good option. But her offer of eggs meant the couple could have a child that shared both of their genetic material.

Some couples hire a gestational carrier. Nebraska does not have laws governing the practice. While still not common, the use of gestational carriers has nearly tripled over the past decade. In 2015, about 2,800 babies were born via gestational carrier, the most recent year for which data was available, according to the American Society for Reproductive Medicine. That’s of nearly 4 million babies born that year in the United States.

In vitro fertilization is expensive and not covered by insurance. Neither are the gestational carrier’s medical costs nor the delivery itself. Matthew estimated that the IVF process, including the genetic testing they chose to add to make sure they selected the healthiest embryos, cost about $40,000. Matthew, a teacher at an Omaha-area public school, and Elliot, a hair stylist, budgeted and saved for the process.

State Sen. Megan Hunt has introduced a bill in the Nebraska Legislature, LB 501, that would require insurance providers to cover IVF. The bill is being held in committee and is unlikely to be considered this year.

Before they could take Cele’s offer seriously, she had to go through an extensive screening process, including a cardiac stress test and an ultrasound of her uterus.

Dr. Carolyn Maud Doherty, of Methodist Women’s Hospital Reproductive Health Specialists, said Cele was in “exceptionally good shape.”

“There are very few 60-year-olds who could do this,” Doherty said. “… It’s a credit to her that she had always kept herself in shape, through diet and exercise. It shows you that if you do those things, you’ll be healthy later in life and be able to withstand a lot of things that could happen to you medically, including pregnancy.”

Cele, of Gretna, also consulted her husband, Kirk Eledge, a retired school administrator. “He just said, ‘What you’re doing is the right thing.’ He had my back the whole way,” she said.

And they discussed it with Matthew‘s two siblings. As Matthew said, “Everyone needed to be on board for something like this to happen.”

Because Cele had been in menopause, they first had to prime her uterus with estrogen and progesterone. Researchers discovered decades ago that the part of the biological clock that’s most important in making IVF work from the woman’s end is the age of the eggs, not of the uterus.

Said Doherty, “It doesn’t recognize the fact that it’s old. The younger the eggs and the healthier the eggs, the more likely this is to work.”

While no one tracks the age of gestational carriers, news reports indicate that Cele isn’t the oldest woman to carry a child. Doherty said the oldest she could find was a Greek grandmother, then 67, who gave birth in 2016 as a gestational carrier for her daughter.

In Cele‘s case, a positive pregnancy test came after one cycle of embryo implantation.

Cele, who’d had her last child before she turned 30, said all the symptoms that go along with pregnancy were heightened this time around, the morning sickness, the heartburn, the sleep loss.

But what inspired her, she said, was envisioning herself at the end of the process handing the newborn off to her son and his husband.

Dr. Ramzy Nakad, a maternal-fetal medicine specialist with Nebraska Medicine, said doctors keep all older expectant mothers under heightened surveillance. Advanced maternal age is a risk factor for both moms and babies. With more women delaying childbirth these days, there are more such cases.

Last weekend, in fact, Cele had a bout of high blood pressure. Doherty said that can happen to any expecting mom, even 20-somethings.

So doctors at the Nebraska Medical Center induced labor. Uma was born — no Cesarean section necessary — early the next morning, weighing in at 5 pounds, 13 ounces.

“Everything was aligned for a good outcome,” Nakad said.

Cele said she didn’t have any second thoughts about handing the granddaughter she’d carried to the new dads. “It was just natural,” she said. “I was completely comfortable thinking, ‘My job is done.’ ”

Now the new family is back home. A friend who’d recently had a baby of her own has been pumping and freezing breast milk to feed the newborn.

Matthew said he’d done a lot of reading about child care and child-rearing in preparation for Uma’s arrival. But he’d feared during the pregnancy that he’d lack some instinct, that maternal something that allows moms and women to nurture others, that it would take to recognize what Uma needed.

“The minute I held her, it all went away …,” he said, adding that he hasn’t slept much for watching her. “I just will provide love to her, and there’s nothing else to it.”

What is surrogacy?

Surrogacy is a method of assisted reproduction that helps intended parents start or grow families when they can’t do so on their own. Learn more about the surrogacy process, and becoming a parent or becoming a surrogate.

What is the difference between gestational surrogacy and traditional surrogacy?

There are two types of surrogacy—gestational surrogacy and traditional surrogacy. In a typical gestational surrogacy arrangement, intended parents create embryos through in vitro fertilization. One or more of these embryos is implanted in a surrogate (sometimes known as a gestational carrier), who carries the child or children to term, but has no genetic relationship to them.

Gestational surrogacies makeup the vast majority of modern surrogacy arrangements. By contrast, traditional surrogates typically become pregnant through artificial insemination, and have a genetic connection to the child or children they carry for their intended parents.

Traditional surrogacy is more controversial than gestational surrogacy, in large part because the biological relationship between the surrogate and the child often complicates the facts of the case if parental rights or the validity of the surrogacy agreement are challenged. As a result, most states prohibit traditional surrogacy agreements. Additionally, many states that permit surrogacy agreements prohibit compensation beyond the payment of medical and legal expenses incurred as a result of the surrogacy agreement.

Finding a Surrogate

Sometimes a family member or friend offers to be a surrogate. This can greatly reduce the cost of surrogacy. However, because not everyone knows a woman in a position to volunteer to be a surrogate, most people find a surrogate through other means.

There are many full-service agencies/firms that will match intended parents to surrogates. When choosing an agency, it is imperative to research the agency’s history. Important questions to ask include how fees are determined and how surrogates are screened. If possible, it is often helpful to speak to former clients of the agency.

A selection of sample questions that parents should ask includes:

  • Is the agency responsive to clients? For example, are they prompt in returning calls and e-mails?
  • Is there more than one person who can respond if the parents’ primary contact is away or busy?
  • Does the firm operate as a team?
  • Regarding screening of potential surrogates:
    Do they meet the surrogate in person?
    Do they evaluate her home environment or is the screening limited solely to a telephone or office interview?
    Do they do reference checks?
    Do they routinely do criminal background checks?
    What kind of information do they obtain about the surrogate candidate’s prior pregnancies to minimize the risk that this will be a high-risk pregnancy?

Some parents choose to search for a surrogate independently. In this case, it is of the utmost importance that both intended parents and surrogates obtain legal advice before making any agreements or signing any contracts. A clear contract can prevent many potential conflicts during the process. Intended parents should also research a potential surrogate’s history to make sure that there is no cause for concern. Additionally, many states that allow gestational surrogacy prohibit traditional surrogacy and/or compensated surrogacy agreements as a caution against perceived coercion.

Surrogacy Qualifications

Most surrogacy agencies and fertility clinics require surrogates to meet the following general qualifications:

a. Be in good physical and mental health;
b. Have carried and delivered at least one child;
c. Have had pregnancies that were all free of complications and were full-term;
d. Be less than 43 years of age (some clinics will accept older woman in certain circumstances; others have younger age cut-offs for all surrogates);
e. Be in a stable living situation; and
f. Not smoke or abuse alcohol.

Egg and Sperm Donors

In addition to locating a surrogate, most people considering surrogacy will need an egg and/or sperm donor.

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