There are many ways to grow a family and many different kinds of families pursuing third party reproduction. Fertility Forms are questionnaires that have been created after decades of experience working with gamete donors, surrogates and intended parents, honing the art of a skilled interview. They have been refined to address all of the ways people grow their families.

What are Fertility Forms?

You’ve been referred an (identified) male and female who are pursuing egg donation with her sister? No problem.

What about a single intended father, whose sister is going to be a gestational carrier and his best friend from college will be the egg donor? Yep, we’ve got that form, too.

Two intended fathers with an agency gestational carrier and an unidentified egg donor? Our questionnaire will give you all the information you’ll need to guide this interview.

Fertility Forms were developed after decades of work with people creating families in multiple ways.  We found that having information about the donor or surrogacy candidates and intended parents prior to meeting them informed our interview, alerted us to specific areas on which to focus, and streamlined the report writing.

These questionnaires are the culmination of years of refining the interview process and addressing key issues in third party reproduction. In addition to giving you demographic information about your clients, you will get a heads up about their feelings about information sharing, pregnancy termination, as well as whether couples are on the same page about their family building plans.

New to reproductive psychology? These LGBTQI friendly forms are crucial tools for the seasoned professional as well as those just getting started. These forms will help you address key topics that are covered in reproductive meetings. While we encourage education, training and consultation prior to engaging in this work, these forms provide a good starting point.

Fertility Forms

  • convey to clients that you have competency and understand the nuances involved in different family building situations
  • give you confidence that you are doing a thorough interview
  • guide your interview. When reviewed before the client(s) arrives, you know how to direct your interview and focus on red flags
  • help you to remember to ask important questions in the interview
  • will aid you in writing the evaluation or consultation report from information provided in the questionnaire, quoting statements in the clients’ own words

How to Use Fertility Forms in Your Practice

Each person should fill out the forms individually. Couples should not complete them together, but use the forms to write about their own thoughts and feelings about infertility treatment. Look for any discrepancies in the couple, places where they have differing feelings and attitudes. For example, in a male/female couple, the intended father may be hesitant about using his sister-in-law’s eggs, but the intended mother is completely comfortable.

These forms are to be securely sent to your client(s) prior to the consultation or evaluation. They should be returned to you in enough time for you to read them and prepare for your interview, identifying any concerns. Providing the client a deadline for return to you is very helpful.

Available individually, in sets or as an entire package, Fertility Forms will become one of your greatest assets in providing thorough, professional and efficient consultations and evaluations.

Sample Questions

General

  • Demographic information
  • Are you taking any medications for a mental health issue?
  • What has been most stressful for you during the treatment for infertility?
  • Why did you choose this family building process versus other family building options?

Recipients

  • Whom have you told about your plans to create your family through egg donation?
  • Who will be carrying this pregnancy?
  • Who are the genetic contributors of these embryos?
  • Whose sperm will be used to create embryos (one of you or both of you)?
  • Do you plan to transfer embryos from different genetics at the same time (from two different sources)? If yes, please explain.

Donor & Gestational Carrier Evaluations

  • Have you ever experienced any sexual trauma (rape, incest, molestation)?
  • Do you plan to be a “donor” or a dad?
  • Have you or your partner ever been convicted of a felony or misdemeanor or been involved in a lawsuit?

Carrie Eichberg, Psy.D.

Licensed Psychologist

Dr. Carrie Eichberg is a graduate of Tufts University and California School of Professional Psychology and currently lives in Boise, Idaho. As a licensed psychologist, Dr. Eichberg counsels clients regarding a variety of reproductive issues including infertility, third party reproduction, donor conception and gestational surrogacy, miscarriage, and grief and loss issues. She also conducts evaluations of donors and gestational carriers for fertility clinics and agencies in both states.

Dr. Eichberg is the author of the children’s book Building My Family: A Story of Egg Donation and Surrogacy and is on faculty at University of Washington Medical School where she serves as psychotherapy supervisor.

Dr. Eichberg is a member of the American Society of Reproductive Medicine, the Idaho Psychological Association, Hawaii Psychological Association and the American Psychological Association. She is a National Health Service Provider in Psychology and holds the Certificate of Professional Qualification in Psychology.

Carole LieberWilkins, MFT

Marriage and Family Therapist

Carole is a Licensed Marriage and Family Therapist in private practice in California, Nevada and Idaho, providing individual and couples counseling, intended parent psychoeducational consultations, and evaluations of egg and sperm donors and gestational carriers.

Carole has been a frequent speaker at multiple professional organizations and can be heard as a contributor to podcasts such as Creating a Family, Dibs, and I Want to Put a Baby in You.

She is a member of the American Society of Reproductive Medicine, the California Association of Marriage and Family Therapists, and RESOLVE. She is co-chair of the Mental Health Committee for the Society for Ethics in Egg Donation and Surrogacy and the Mental Health Director of Parents via Egg Donation.

Carole is the co-author of Let’s Talk About Egg Donation:  Real Stories from Real People, which guides the reader from diagnosis to parenthood through egg or embryo donation.  Let’s Talk About Egg Donation also provides scripts for talking to kids about donor conception at different ages and stages.

Professional Consultation

For professional consultation regarding reproductive psychology, assessment with the PAI, or the use of Fertility Forms, contact Carrie at Carrie@dreichberg.com or Carole at FamilyBuildingCLW@gmail.com.

Contact

Lauren Cross

Fertility Forms were edited by Lauren Cross

She has been published in several anthologies, including Shaking the Tree and Three Minus One, The San Diego Union-Tribune, and The San Diego Decameron Project. She also content-edited the groundbreaking book, Let’s Talk About Egg Donation. Learn more at ThisIsLaurenCross.com.