Eurasia Surrogacy: Interview Dr. Tamar #2: How It Works, Risks, & Priceless Rewards

  TBILISI, GEORGIA - 10/13/2017 (PRESS RELEASE JET)

Eurasia Surrogacy: Interview with Dr. Tamar #2: How It Works, Risks, & Priceless Rewards

"It's Michael Vanderpool here today with Eurasia surrogacy and egg donation international and we are
with Dr. Tamar in a follow-up interview and basically three areas of questions that I have for her today.
thank you for taking the time to answer these questions. the first one is can you explain the process in
the surrogacy program here in Georgia that you worked with or some years now can you tell me how
that works to make it simple the steps in the process?" yes for sure when the patients are coming to us
in Georgia because in many countries surrogation and donation programs are prohibite,not only
prohibition but couples are having problems because some ladies are not having sufficient ovarian
reserve they are having defective eggs or they are higher ages so they need to take egg donors. but
besides egg donors we can offer also sperm donation.  As for surrogation: surrogate mother, to explain
simply is just carrier of the baby but she is not genetically bonded to the baby. So surrogate mother is
just serving us with her womb. Patients are coming to us we have our own surrogation donation center
we are Hospital with IVF department, so every test, every procedure is carried out in IVF department in
our hospital, and as we have our own surrogation and donation center with database of egg donors and
surrogate mothers. We offer them egg donors and they choose from appropriate egg donors, and we
, doctors choose surrogate mothers. Mainly selecting egg donors are dependent on the patients, by
choosing them according to nationality, also body complex appearance, eye color ,hair color and etc.But
surrogate mothers are chosen by medical doctors as we assess their uterus first, if we consider them
appropriate for surrogation we offer them to our patients . Sometimes patients are not even
willing to meet egg donors and surrogate mothers , we follow patients confidentiality , besides it they
have to make trifold agreement in notary office . The first step is that they refer to us with need of egg
donor or surrogate mother. We provide them with database for surrogate mothers and egg donors, if
they agree with us we are starting to investigate egg donors and surrogate mothers. We make every
necessary tests in our department and at the same time they are making an official agreement in
notary house, because after child birth they must expatriate baby, without this trifold agreement they
will not be able to expatriate the baby. for one time they have to arrive, or make power of attorney on
reliable person, if they can't arrive in Georgia to sign this agreement. Then we start the procedure of
IVF, stimulation of the egg donor, if couple need egg donation, at the same time we are preparing
surrogate mother, in this way we coincide their menstrual periods , the last step is transferring
embryos in surrogate mother.  Step by step we are informing our patients how many embryos
we get, how is the quality of embryos, how many embryos we plan to transfer. According to our law,
there is no prohibition how many embryos we are transferring, it depends on our decision, also it
depends on the age of the surrogate mother, on the quality of the embryos. So according to researches,
a single embryo transfer is getting more popular, but in transferring several embryos like two or three,
we are increasing success rate, we are increasing chance of getting pregnancy.  But also we prefer single
fetus pregnancy then multiple one. We are informing surrogate mother and we must get informed
consent on the quantity of embryos surrogate mother agrees to be transferred into her uterus. "Ok. so
in this process because it sounds a little bit about making some choices some decisions with Dr." Yes.
"And the doctors are making decisions about the choice of surrogate mother about the necessary
medical requirements." Yes. "So in this process what are the things that can go wrong? so that the
other party, the people that are using this surrogacy program, so that they aren't left with any surprises.
Can you explain this part?" yes every procedure contains within itself some risks but not
always happens complications. The complication that can occur during the stimulation of the egg donor
is Hyperstimulation syndrome , because we're using special stimulation medication, we use special
protocols to prevent this complication, but anyway sometimes we are getting hyperstimulation

syndrome, during procedure of ovarian retrieval when we are taking eggs from the follicles there is
chance to damage vessels nearby the uterus, nearby the ovaries, but it's also very rare. It's a rarity, so if
complication happens , we inform the patient about the complication the patient and they must cover
the expenditure, About surrogate mother complication can happen for sure, we are controlling
surrogate mothers on weekly basis; every day it's impossible to control (monitor them) for sure because
we are just breaking their rights, but on a weekly basis our representative visits her and checks where
she lives if she takes medication which we prescribe but sometimes they are forgetting to take
medication. If they forget any medication like estrogen, or prescribed medication maybe procedure of
transfer will be cancelled because menstrual cycle will start in surrogate mother and we will not be
able to transfer embryos. If we get pregnancy during pregnancy we can have complication like
miscarriage, because every pregnancy contains risk of miscarriage and in IVF also there is a bit higher
risk of miscarriages, or premature birth . Everything, every complication is informed to patient, that
surrogate mother is well or surrogate mother feels bad, or there is miscarriage , any next steps are
discussed with the patient and for sure surrogate mother and the patient are following signed
agreement, patients is to cover this expenditures as well, but nowadays we are trying to avoid these
complications We have different protocols but anyway in any procedures we can't tell 100% than one
will not get any complication so it isn't dependent upon us only.There is mentioned in agreement that
surrogacy agency; donation center can change the surrogate mother in one program double (two) time. If I
don't get pregnancy in the surrogate mother, as Dr. I have the right to change the surrogate mother.
also we are discussing changing of the surrogate mother with the patient, because if we are taking new
surrogate mother, surrogation and donation agency will supply new surrogate mother, but the price of
the agreement will be covered again because agreement will be changed as another surrogate mother
is a different person and also tests and investigation must be done on this person so expenditure will be
covered by patient, because of it we are discussing it with the patient. If after 4 trials we don’t get
pregnancy, in one program, we can refund 25% of the sum. We are trying to make high success rates,
we are having good equipments , qualified embryologists. We have more than 100 babies born in our
program, in our hospital, and in our previous hospital we were working. But in Georgia there
are several clinics and the total statistical base for sure is different. In our hospital we have been
working for 15 years,our university I.Zhordania Institute of Human Reproduction was the first who
founded IVF department. And there were born for sure more babies, but in my practice of 6 years,
more than 100 babies are born. "Ok, now that's what I wanted to ask you about, is that clinic Israeli
based?" It isn't Israeli based. It was based in Georgia in early 1960's, I.Zhordania Institute of Human
Reproduction , but we are have consultant doctors in Israel from Sourasky medical center from Sheba
Clinic, also we have communication with Moscow with NGC Clinic, "And you just returned from St.
Petersburg?" Yes, St. Petersburg has a very good clinic NGC Clinic, they opened it also in Moscow , we a
have communication with Ukrainian doctors as well from Professor Dachno Human Reproduction
Institute . As for me, I am communicating with United States Doctors, I am going to Alabama University,
there is IVF Department, I will be there for a month. We are having tight communication with foreign
doctors, so we are sharing our experiences, sometimes we need some advice, so It's no problem if our
patient wants to be consulted from Israeli doctor or from American doctor or from Russian doctor, it's
no problem we can arrange this consultation, online consultation. So we can offer this service also for
our patients. "Ok, so in my experience, my cousin who's LGBT, a female/female couple, and they had
the IVF procedure, and they had twins. They had beautiful little girls, and they still have this family
today. They had this family created by the IVF and the processes, but they didn't need surrogacy,

because she had the pregnancy, but I assume the family creation process you, know having a child come
from this method, this program is quite successful because you mentioned that it's at least 100 children
that been produced through this surrogacy program here?" Yes, this is more than 100 children, and the
problem in Georgia is about mentality. Maybe you know about it, that our main patients are from
Azerbaijan, from Georgia, from Russia, from Israel, so they don't like to release their information that
they made through surrogation or donation program. sometimes about surrogation it's easier, because
if they are not pregnant then someone is pregnant, instead of them, on behalf of them. But about egg
donation and even about IVF procedures they are hiding it. Sometimes we are having patients then
they are having pregnancy and then they are not coming to us, so follow-up is very complicated
sometimes because they are trying to hide this procedure. sometimes when we are meeting even in
other institutions they don't even say hello to us even though we get pregnancy after 10 or 15 years of
infertility, we understand this because this is a bit difficult mentality in Eurasia so sometimes follow up
is a bit complicated and this is the number that we are having live birth rates. our main aim about this
hospital and about IVF department is to get not only pregnancy, but healthy live child, so childbirth is
very important for us and our happy families, because in our practice there are different cases for sure.
Even when we had patient with secondary infertility. she delivered at age 28 and after this she didn't
have any other pregnancy she made in other countries 16 IVF procedures without results and she was
referred to us so we decided to offer to make PGD diagnostic even though PGD diagnostic wasn't
established in Georgia then they made it in their home country. and it appeared that six embryos which
was got they were all defective. So there was not carried out embryo transfer, we offered them egg
donor and now they are parent of a beautiful girl. They are living in Turkey so they wish to make freeze
embryo transfer procedure as we have their blastocysts frozen ,now this lady is 43 years of age. This is
happiness for doctors for sure this is happiness to for patients after long time waiting for baby "16
failures?!" 16 failures, Yes. "And IVF procedures?"and the problem was an embryo because embryo
quality was poor. "Wow". It was genetically tested and embryos were of poor quality, though
morphologically when embryologists were assessing the embryos they were first grade, second, first
grade so they were transferring but the results was not got . After PGD diagnosis, it appeared that the
embryos were of poor quality genetically, so we changed her eggs with egg donors, and so we got her
pregnancy. "That's amazing, and that's a really beautiful story. It's a struggle in the beginning but they
had the success, and it was after 16 trials (in another program), and that's just such an amazing thing.
Today we talked about you have the Stanford (University) educated Georgian that has the Lab?"  Yes,
several weeks ago, Georgian guys opened PGD Laboratory, not only PGD, but Genetical Laboratory, so
they will work on PGD with NGS (NEXT GENERATION SEQUENCING - NASA Space Agency) method.

So the founder is a lawyer who was studying in Stanford University. He's also reading lecture at Stanford
University. Doctor of Genetics who Is working in this lab is famous Georgian geneticist working in this
lab, he was also serving in the United States. "As a geneticist in the United States?" Yes, yes, they
returned here in Georgia, so they opened this lab and this will be the highest approach in Georgia,
because neither clinics are having PGD diagnosis in Georgia so we will communicate with them, they will
make biopsy of the embryos and they will investigate these embryos, so this will be a very good and the
high approach because just now if patients are asking us about PGD, we have to send this embryos in
frozen form to other countries. Mainly this is Ukraine because sending to Israel, we are communicating
with Israel but about biological samples it's very complicated, we are sending embryos but to get them
back is very complicated. So we are trying to arrange this problem with government of Israel. But just
now we are communicating about PGD Diagnostics with Ukraine and Belarus. "Fantastic. I know that

Ukrainians take their medicine very seriously. As you know I spent 13 months in Kyiv Ukraine, so I am
very familiar with Ukraine, and I've been in Russia as well. Well, I think that's basically what I wanted to
ask you for today. And that's very encouraging I'm sure, for people that have either tried this process
and didn't have success, or maybe they know people that have had success, like my cousin, who I think
now lives in Michigan, who originally did the process in Missouri, which as you know is where I am from,
citizen of America, the United States . I thank you for time. This is Eurasia Surrogacy & Egg Donation INT
International interviewing today with Dr. Tamar in Tbilisi, Georgia."

End of Interview by Rev. Dr. Michael R Vanderpool, Tbilisi, October 6, 2017 - U.S. Press Association

https://www.youtube.com/watch?v=9sAXlgWQopA