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SPERM DONATION AGREEMENT (IVF-ET)

THIS AGREEMENT is between ("Intended Mother") and ("Intended Father") (collective "Intended Parents") and ("Intended Sperm Donor") (either of the above referred to as a "Party" or collectively as the "Parties").

IN CONSIDERATION of the mutual promise contained herein, the sufficiency of which is hereby acknowledged, and with the intention of being legally bound hereby, the Parties agree as follows:

1. BACKGROUND

("Intended Mother") warrants that she is currently married to "Intended Father"). have been unable to have a child unassisted. They both want to carry and give birth to a child they will raise together. ("Physician") has advised that In Vitro Fertilization Embryo Transfer (IVF-ET) with donated sperm may be a viable method of conception for them.

Their friend, ("Intended Sperm Donor"), who warrants that he is unmarried, wants to assist the Intended Parents in their desire to gestate, give birth to and parent a child by serving as a known Sperm Donor for them without thereby having or retaining any parental or other obligations or rights whatsoever to the Child.

The Intended Sperm Donor has agreed to assist the Intended Parents to attempt to have a child through IVF-ET,a process in which eggs retrieved from the Intended Mother will be combined with the Sperm Donor's sperm (which will likely be fresh but may be previously frozen and stored at ( ) or fresh sperm may be frozen for future use) to form one or more embryos, to be transferred to the Intended Mother, who will attempt to carry and give birth to the Child ("Child" shall include any child or children born from the use of eggs from the Intended Mother and fertilized with the Intended Sperm Donor's sperm that Intended Parents do not donate to other prospective parents). All Parties agree that it is their intent that in serving as a sperm donor, will not acquire any rights to or obligations for the Child.

The Intended Parents and Sperm Donor have agreed to use the services of Dr. _________ and her staff a ("Fertility Center") for medical care related to achieving the purpose and intent of this Agreement. Before entering into this Agreement each of the Parties has been evaluated by and consulted with a physician from, affiliated with, or approved by the Fertility Center. Each Party represents that he or she has had the opportunity to have all tests and the results, medications, and procedures associated with the IVF-ET and sperm donation satisfactorily explained, and to have all medical and psychological questions answered to his or her complete satisfaction. Additionally, before entering into this Agreement, the Parties have each carefully considered the risks, benefits, and advisability of participating in this sperm donation and Artificial Insemination arrangement. The Parties have consulted with legal counsel, and understand that Sperm Donation Arrangements may present new and unsettled questions of law. Additionally, the Parties have been advised that parenting agreements between Intended Parents and an unmarried known Sperm Donor do not provide complete legal and financial protection for the Intended Parents, Intended Sperm Donor, or a Child. In an effort to protect all parties, and, most importantly, to protect the security and well being of any Child conceived as a result of this sperm donation and AI arrangement, the Parties voluntarily enter into this Agreement which states their intentions, provides guidelines for resolving any future disputes, and affirms their intent to be legally bound to the terms herein.

2. PURPOSE AND INTENT OF AGREEMENT

 

The purpose of this Agreement is to provide a means for the Intended Parents to become the legal parents of a Child conceived by egg(s) retrieved from the Intended Mother, and fertilized by sperm from the Intended Sperm Donor. To achieve this purpose, the Intended Parents and the Intended Sperm Donor agree to participate in an In Vitro fertilization procedure ( IVF-ET) in which an attempt will be made to retrieve one or more eggs from Intended Mother to be fertilized In Vitro with sperm provided by the Sperm Donor to form one or more embryo(s) to be transferred to the Uterus of Intended Mother enabling her to attempt to carry and give birth to a Child. The Parties have been informed and advised that all sperm donated by Sperm Donor could be frozen and quarantined for a minimum period of six months before Intended Mother’s eggs are inseminated in accordance with the American Society of Reproductive Medicine guidelines in order to provide maximum protection to the Intended Mother, Intended Father and Child. However, the Parties may agree to waive this guideline in spite of their lawyers’ advice to do so, and instead use the exception to the guidelines for known sperm donors which do not require a six month quarantine period.

Except as otherwise provided for herein Section 4, the Parties intend and agree that the Intended Parents are entitled to and will assume all parental rights, obligations, and responsibilities for any embryos formed or Child conceived, from the moment Intended Mother’s eggs are combined with Sperm Donor’s sperm throughout the life of the last surviving of the Child or any Party to this Agreement.

3. INTENDED PARENTS’ ASSUMPTION OF RIGHTS, RESPONSIBILITIES AND OBLIGATIONS TO THE CHILD

All Parties acknowledge that the Child will be the genetic offspring of Intended Mother and if sperm from the Sperm Donor is used, the genetic offspring of the Intended Sperm Donor. Nonetheless, the Parties each intend and agree that the Child conceived as a result of this embryo transfer arrangement shall be the legal Child of the Intended Mother and Intended Father. Intended Mother will be the gestational, genetic, custodial, and the legal mother. Intended Father will be the custodial and legal parent of the Child. Neither the Intended Parents nor the Sperm Donor intend for the Sperm Donor to be held responsible for custody, support, inheritance rights or welfare of the Child. The Intended Parents release the Intended Sperm Donor from any obligations or duties for the Child and agree to assume all such obligations. In the event of any future change in the law that could be construed to impose any legal parentage of the Child upon , Intended Parents shall not impose any such obligations upon and shall not hold responsible for any financial or other obligations to the Child. The Sperm Donor relinquishes any rights or responsibilities now or in the future in relation to the Child. The Intended Parents agree to assume all parental rights and responsibilities and not to impose any obligations upon the Sperm Donor prior to or once a Child is conceived regardless of any changed circumstances or unforeseen events including, but not limited to, laboratory error, marriage or divorce, changed financial resources of any Party, illness, disability, or death of Intended Mother, Intended Father, and/or Sperm Donor, or illness, birth defect, or any disability of the Child, birth of multiple Children, or breach of this Agreement by any Party. The Intended Parents agree to assume all responsibility for the custody, financial support, inheritance rights, and welfare of the Child. All Parties agree that it is their intent that the Intended Parents shall be completely responsible for any Child conceived and born as a result of this sperm donation and IVF-ET arrangement. This Agreement is intended to prevent any further action from being required to establish the Intended Parent’s parental rights. All Parties intend and agree that Intended Mother’s and Intended Father’s name shall be on the Child’s birth certificate as the legal Mother and Father respectively. Nevertheless, all Parties understand that the law in __________ regarding children conceived by sperm donation from a known Sperm Donor may not provide clear guidelines regarding support and custody of a Child, and therefore, each Party agrees to cooperate, at Intended Parent’s expense, to complete all documents and/or actions that may be legally necessary or advisable to establish the Intended Father as the legal parent of any Child conceived as a result of this arrangement. Intended Sperm Donor agrees not to contest Intended Parent’s right to be the sole legal parents of the child, and Intended Parents agree not to seek child support or financial obligations to the Child from the Sperm Donor. The Sperm Donor agrees not to seek custody rights to the Child. Should he do so in violation of the terms of this Agreement, all court costs, legal fees and expenses of all Parties shall be the responsibility of the Sperm Donor.

4. INTENDED PARENTS’ ASSUMPTION OF RIGHTS, OBLIGATIONS AND RESPONSIBILITIES FOR EMBRYOS

Once the Intended Mother’s eggs have been combined with the Sperm Donor’s sperm, the Intended Parents shall have the full right to determine the disposition of all pre-embryo's or embryos, except as provided for herein. The Intended Parents shall have the right to have the (pre) embryos transferred to Intended Mother’s uterus, shall have the right to cryopreserve (freeze) any unused embryos for future use for herself, arrange to have excess embryos transferred to a gestational surrogate with the intent of Intended Parents becoming legal parents of the Child, donate excess embryos to Intended Mother’s sister or, with ’s prior written consent, to an agreed upon couple, or allow unused embryos to thaw and be discarded. Intended Parents do not currently intend to donate excess embryo(s) to research. In the event Intended Parents transfer embryos to a Gestational Surrogate, they shall comply with all applicable laws to establish their parentage and shall, at a minimum, enter into an agreement with such gestational surrogate wherein she holds sperm donation harmless for any and all damages. It is not the Intended Parents’ current intent to allow the embryos to thaw. If the Intended Parents have completed their family building and the Parties have not found other acceptable intended parents to whom to donate to or choose not to utilize the embryos, then either the Sperm Donor can decide to pay for ongoing storage, or the embryos can be allowed to thaw. In the event Intended Parents desire to thaw and dispose of unused embryos, Intended Parents shall provide Sperm Donor with thirty (30) days prior written notice or such thawing and disposal. Prior to such planned thawing and disposal, Intended Parents intend to give Sperm Donor the option of accepting a donation of any of the cryopreserved pre-embryos to Sperm Donor. Should accept the donation and/or utilize the embryos to produce a child, all costs of storage, transfer, or medical treatment shall be Sperm Donor’s. Additionally, before any future pre-embryo or embryo transfer occurs, Intended Parents agree to obtain Sperm Donor’s contemporaneous written consent before any cryopreserved embryos are transferred to any remaining frozen sperm samples are combined with eggs. No such future (pre) embryo transfer shall occur without such contemporaneous written consent by the Sperm Donor. The Intended Parents represent that they shall not donate any excess embryos to other potential intended parents without the contemporaneous written consent of Sperm Donor. The Intended Parents and Sperm Donor represent that in the medical consent form pertaining to future disposition of excess cryopreserved embryos, Intended Parents have designated future disposition of excess embryos in keeping with the agreements made herein and specifically represent that they have informed the Fertility Center in writing of the requirement of the contemporaneous consent by the Sperm Donor for future (pre) embryo transfers or donations. Additionally, except as provided for herein, the Intended Parents and Sperm Donor understand that Intended Parents’ assumption of the care, custody, and control of all pre-embryo's, embryos, or any Child conceived is irrevocable once the Intended Mother’s eggs have been combined with the Sperm Donor’s sperm. This assumption of parental rights and responsibilities shall enable Intended Parents to have the right to plan for subsequent guardians hip or care for their Child. Intended Parents represent that, by the twenty-fourth (24th) week of a confirmed pregnancy, they shall establish an estate plan naming guardians for the Child as provided for hereinafter.

The terms of Intended Parent’s current agreements with respect to the disposition of any unused embryos are further detailed in the Informed Consent Form for Cryopreservation of Pre-embryo's. The Intended Parents and the Sperm Donor agree that this Agreement, and/or the terms of any informed consents to cryopreservation or disposition of embryos that Intended Parents shall execute in the future, may be relied upon by medical personnel. Intended Parents also represent that in the medical consent forms they have executed, they have not selected to donate excess embryos to another couple for the purpose of gestating and giving birth to a child and will not do so without Sperm Donor’s contemporaneous written permission.

5. MEDICAL AND PSYCHOLOGICAL EVALUATIONS

 

All the Parties represent that to the best of their knowledge each of them is free from serious medical and psychological problems that could cause injury, defect, disease, or severe psychological or emotional distress to any Party of the Child in the course of this embryo transfer arrangement or that any such medical or psychological problems have been fully disclosed to all other Parties. Each Party has disclosed to all other Parties any medications they are currently taking and agrees to discuss with appropriate medical physicians, the safety and impact of remaining on or withdrawing from such medications during the anticipated sperm donation arrangement and if relevant resulting pregnancy. Each Party acknowledges, however, that in spite of best efforts no Party can guarantee that he or she is free from any such problems, nor that unanticipated events or circumstances will not adversely affect a Party or a Child.

Nonetheless, to reduce the probability of such risks occurring, the Parties have completed medical evaluations which have been planned, conducted, and/or supervised by personnel of or approved by the Fertility Center. The Parties agree to undergo any other reasonable testing requested by the personnel of the Fertility Center prior to or during the IVF-ET process. In addition, all Parties acknowledge that they have participated in a psychological evaluation and counseling interview with Dr. _________, a licensed clinical psychologist, to inform themselves of potential psychological risks, and to determine whether there appear to be any significant psychological reasons why any Party should not participate in the planned collaborative reproductive arrangement.

Each Party has provided background information to the Fertility Center and to their lawyer prior to participating in this sperm donation agreement. The Intended Parents acknowledge that the Fertility Center and the Parties are relying on the accuracy of the information provided to determine whether to proceed with this arrangement. Each Party represents that all information they have provided or will provide to their lawyer, the Fertility Center, or the designated mental health professional, or any of their designees, assigns, or employees is accurate and complete to the best of each Party’s knowledge. Such representation of accuracy and completeness includes information regarding current health; medical history; medication use, insurance coverage; past and present drug and alcohol use; genetic background; marital status; specimens provided for medical testing including blood and or urine tests to screen for HIV or other communicable diseases; reproductive history; allergies; information requested during the course of psychological evaluations; and all other information requested to determine the appropriateness of proceeding with the sperm donation IVF-ET arrangement.

Each Party agrees to assume full responsibility for obtaining adequate medical and psychological information and/or counseling to insure that he or she is fully informed to his or her complete satisfaction of the potential risks related to this arrangement. Prior to proceeding with the IVF-ET procedure and throughout the life of this arrangement, each Party agrees to make reasonable efforts to disclose to the other Parties and to the Fertility Center any fact that he or she should reasonably believe is relevant to evaluating the medical, psychological, or other potential risks of this sperm donation arrangement.

6. IN-VITRO FERTILIZATION, SPERM DONATION, EMBRYO TRANSFER (IVF-ET) CYCLE

After the evaluation and counseling process has been completed to each Party’s full satisfaction, Intended Parents and Sperm Donor agree to make every reasonable effort to participate in at least one IVF-ET cycle to be conducted and/or supervised by personnel of the Fertility Center. The cycle is described more fully in the medical consent forms signed by all Parties. Generally, such cycle is expected to include the following steps:

The Intended Sperm Donor has or will undergo diagnostic tests before providing sperm which will either be used immediately or frozen ("cryopreserved") for future use.

If Intended Parents would like to use any cryopreserved sperm from Sperm Donor, other than cryopreserved sperm currently being stored at the Fertility Center, such sperm shall be provided at Sperm Donor’s option, from currently cryopreserved sperm stored at ____________;

The Intended Mother will undergo a series of diagnostic tests and monitoring procedure, and will take drugs prescribed to increase the number of viable eggs available for retrieval and to increase the likelihood that Intended Mother will conceive;

The Intended Mother will undergo an egg retrieval procedure in which egg(s) will be removed from her ovaries;

The Fertility Center will combine Intended Mother’s retrieved eggs with sperm provided by Intended Father in a laboratory, in an attempt to fertilize the eggs and form pre-embryo's; and

If viable pre-embryo's are formed as the result of this IVF-ET procedure, some or all of them will be transferred into Intended Mother for the purpose of achieving a pregnancy, which Intended Mother will then attempt to carry to term.

Alternatively, if Intended Father’s sperm does not fertilize eggs successfully, sperm from the Sperm Donor will be combined with Intended Mother’s retrieved eggs to be transferred to Intended Mother for achieving a pregnancy, which Intended Mother will attempt to carry to term.

If Sperm Donor’s sperm is utilized, Intended Parents agree to have paternity testing performed on the Child to determine the Child’s genetic father and agree to disclose the results of such testing to Sperm Donor. The cost of paternity testing shall be the responsibility of the Sperm Donor. The Parties acknowledge that the IVF-ET medical process is physically and emotionally demanding, and may require daily administration of medications, orally, intramuscularly, or vaginally by Intended Mother, and daily testing and participation in medical procedures. The Parties agree to follow all reasonable instructions given to them by the Fertility Center and to cooperate fully with one another and the medical personnel. Each Party represents that all tests, medications, and procedures related to the assisted reproductive arrangement have been described in detail by the Fertility Center Staff and have been further described in the Intended Parent’s medical consent forms which are incorporated into this Agreement by reference and which each Party has read and been given the opportunity to have all questions answered to his or her complete satisfaction before the embryo transfer. The Parties expressly agree that to the extent that there is any conflict between the terms of any forms of consent executed by any of the Parties, and this Agreement, the terms of this Agreement shall override and replace the terms of those consent forms as to the rights and obligations of the Parties with respect to each other and to the Child.

7. PREGNANCY OF THE INTENDED MOTHER

 

Intended Parents acknowledge that while Intended Mother is taking fertility medications, she is at an increased risk of becoming pregnant and should she become pregnant is at an increased risk of conceiving multiple children. Intended Parents acknowledge that they will be responsible for all obligations and expenses related to pregnancy, termination, birth and/or care of any child(ren), she may conceive and agree to release the Intended Sperm Donor from any obligations for the same.

The Parties also acknowledge that should the Intended Mother become pregnant, she will have the sole legal right to determine if she should have an abortion or a multifetal pregnancy reduction. Understanding the ultimate decision making authority remains with the Intended Mother, all Parties agree that if there is ever a choice between the Intended Mother’s or the baby’s health or life, the Intended Mother’s health will be given priority.

8. HEALTH PRECAUTIONS AND RISKS

 

All Parties agree to refrain from engaging in any behavior prior to and during the IVF-ET process that might reasonably be expected to pose a known risk to the health of the Child and/or the Intended Parents as the result of the embryo transfer. Such behaviors include, but are not limited to, actions that increase the risk of the transmission of sexually transmitted diseases; the unauthorized use of drugs whether prescription or nonprescription, legal or illegal; smoking; and drinking alcohol. All Parties agree to inform the Fertility Center of all medications and supplements they are currently taking. Intended Mother and Sperm Donor also agree to follow all reasonable instructions from the Fertility Center during the course of the sperm donation and IVF-ET process.

As in unassisted conception, despite all Parties’ best efforts to insure the health of the Child, the Intended Parents acknowledge that various complications, including but not limited to medical problems associated with the premature birth of the Child, or genetic and congenital abnormalities could occur. Such problems may not be detected by prenatal tests or medical screenings, and a Child might be born with congenital abnormalities, or may develop health problems. Regardless of any genetic, congenital, or other health or emotional problems the Child may exhibit or develop, Intended Parents, regardless of breach of this Agreement by any Party, agree to take custody and assume all legal, financial, and medical responsibilities for the Child, just as they would if the Child had been conceived without assistance of sperm donation and embryo transfer.

acknowledges that as an Intended Sperm Donor, he may have information, now or in the future relevant to the Child’s medical care. therefore agrees in the event of the Child’s medical need, Intended Parents or the Child will have the right to contact him in the future to determine at that time if he is willing to share additional medical information to promote the Child’s health and well-being. Similarly, in the event of medical need to or his future offspring, Intended Parents agree that may contact them to see if they are willing at that time to provide additional information or assistance to promote ’s or his future offspring’s well-being. All Parties reserve the right to prevent any such future contact by providing the other Parties to this Agreement written notice of such desire to stop contact.

9. EXPENSES AND INSURANCE

 

Intended Parents represent that Intended Mother is covered by a policy of medical insurance that provides coverage for pregnancy and illness, including major medical and hospitalization. All Parties agree that Intended Mother will make best efforts to maintain her health insurance and will use such medical insurance to the fullest extent possible to pay for any pregnancy, delivery, or medical complications that might occur as a direct and proximate result of her participation in the IVF-ET process. All Parties acknowledge that because merely intends to be a sperm donor without parental rights or obligations, Intended Sperm Donor’s insurance policy will not cover costs of Intended Parents’ infertility treatment, Intended Mother’s pregnancy, prenatal care, delivery, complications from any involved medical procedure, or medical care for the Child.

The Intended Parents agree that they will pay for all covered and uncovered medical expenses and costs associated with the cryopreservation of sperm stored at Fertility Center, any medical assessments and testing to facilitate his service as an Intended Sperm Donor, fertility treatment, medications, pregnancy, embryo transfer or birth of the Child or any complications resulting there from. If Intended Mother and Intended Father achieve a pregnancy without the use of ’s sperm, and/or the Intended Parents have completed their attempts at family building, will be given the right to control the future use of the unused cryopreserved sperm at Fertility Center which has not been combined with Intended Mother’s eggs, at Sperm Donor’s expense. All Parties acknowledge that all property rights in and obligations to ’s cryopreserved sperm at _________ belong to , and not Intended Parents, unless provides his written consent to the use of such cryopreserved sperm.

10. PAYMENT OF CHILD SUPPORT

 

It is the intention of the Intended Parents and Intended Sperm Donor that if a Child is born as a result of this sperm donation arrangement, Intended Parents shall be given legal and physical custody of the Child and Intended Sperm Donor shall have no right to custody and no obligation for Child support. The Sperm Donor agrees to relinquish any rights to the Child now or in the future. The Intended Parents agree to release the Sperm Donor from any obligations he might have to the Child for child support and agree to assume all responsibility for the financial responsibilities for the care, control, custody, and financial support of the Child.

11. ILLNESS OR DISABILITY

 

The Parties understand that during the course of a pregnancy or delivery, the Intended Mother may be placed on bed rest or otherwise restricted. In such event, the Intended Mother agrees to make every reasonable attempt to maintain her health insurance and agrees that the Intended Sperm Donor shall have no financial obligation or duty to help with the costs of such complications or other medical expenses incurred as a result of such other disability.

12. LEGAL COUNSELING AND FEES

 

All Parties acknowledge the importance of being fully informed about the legal issues, obligations, and risks associated with this embryo transfer sperm donation arrangement, and therefore have consulted legal counsel. The Intended Parents represent that they have received legal counsel from ___________, of the Law Offices of ___________, who is licensed to practice in the State of ___________.

The Intended Sperm Donor represents that he has received legal counsel from ___________ of the Law Office of ___________ and Associates who is licensed to practice in the State of ___________. Each of the Parties represents that he or she has freely chosen representation, that their attorney has provided opportunities to review and discuss this Agreement and the embryo transfer arrangement in detail, and provided a full opportunity to have all questions regarding the terms and meaning of this Agreement answered to each Party’s satisfaction. All costs of the Intended Sperm Donor’s legal consultation shall be or have been paid by the Recipient..

13. ADDITIONAL PSYCHOLOGICAL COUNSELING

 

Before entering into this sperm donation arrangement, all Parties represent that they have participated in a psychological screening interview with Dr. ___________ to learn about the psychological issues involved in participating in this sperm donation arrangement, and to determine whether there appear to be any serious psychological reasons why they should not proceed. All Parties agree that it is very important for Intended Parents and Intended Sperm Donor to have the opportunity, if needed, to receive psychological advice and counseling to assist them as they participate in the embryo transfer sperm donation arrangement. Therefore, upon any Party’s request, before and up to six months after the birth of a Child, the Parties agree to participate in joint psychological counseling where all Parties presence is required, either in person or telephonically, around psycho-social issues related to this embryo transfer sperm donation agreement. Intended Parents agree that, if possible, they will attempt to have their own medical insurance cover the costs of any such counseling, and accordingly, will attempt to select a mental health professional who is covered by their health insurance. shall not be required to submit any such mental health claims to his medical insurance. If the Parties proceed with group counseling, each Party will be responsible for the payment of their own share (one-half) of such counseling. If group counseling is requested by Intended Parents, ’s liability for such counseling shall be limited to the amount of Seven Hundred Fifty Dollars ($750.00). If counseling is requested by , Intended Parents’ liability shall not exceed $750.00.

14. ESTABLISHMENT OF LEGAL PARENTAGE

 

All Parties intend and agree that consistent with ___________ law, the Intended Parents will be the legal parents of the Child and Intended Sperm Donor shall have no parental rights or obligations to the Child. Intended Parents are aware of and agree to comply with the requirements set forth in the ___________ Parentage Act to establish their legal parentage. Therefore, all Parties agree to include both Intended Mother and Intended Father’s names on the birth certificate(s). Furthermore, because the future legal status of any Child conceived with the assistance of known sperm donation and IVF-ET may be uncertain, all Parties agree to participate and cooperate in any legal proceedings, and to execute any legal documents, as may be necessary or legally advisable as determined by a qualified attorney to establish the Intended Parents as the exclusive legal parents of the Child. Intended Parents agree to pay all reasonable fees and court costs and reasonable travel expenses incurred in the process of establishing themselves to be the Child’s legal parents or required to relieve Sperm Donor of any obligations to the Child with one limited exception. In the event that Intended Sperm Donor attempts to establish himself as the legal father of the Child, in violation of the terms of this Agreement, all legal costs including Intended Parents’ costs in defending against such action, court fees, and expenses for so doing shall be the responsibility of the Intended Sperm Donor.

15. MARRIAGE, DIVORCE, DEATH OR CHANGED CIRCUMSTANCES

 

If any Party marries, separates, or their financial, emotional, or other life circumstances change, or if one or any of them should develop health problems, become disabled, or die either before or after the Child’s birth, all Parties nevertheless agree that this Agreement shall continue in full force and effect, and further agree that parental rights and obligations shall not be affected by the fact that the Child was conceived and born with the assistance of embryo transfer and sperm donation. In such event, the Intended Parents shall retain all parental, custodial, and other rights and obligations to the Child. In the event that both the Intended Mother and Intended Sperm Donor die prior to or after the birth of the Child, all Parties agree that the Child shall be placed in the custody of the Intended Father. To provide for the possibility of both Intended Parents dying before the birth or after of the Child, the Intended Parents agree to execute wills or estate plans clearly designating a guardian and a minimum of two (2) successor guardians no later than the 16th week of a viable pregnancy. In the event that no listed guardians are willing or able to serve in the role as guardian of the Child, Intended Parents intend to name as the final successor to avoid having the Child become a ward of the State. Each Party to this agreement acknowledges that his or her obligation to fulfill the terms of this Agreement will continue in force regardless of any such event, whether anticipated or not.

16. ASSUMPTION OF MEDICAL, PSYCHOLOGICAL AND LEGAL RISKS

 

Each Party acknowledges that the medications administered and the medical procedures performed in furtherance of this sperm donation IVF-ET arrangement may involve known and unknown medical risks to all Parties and to the Child. Furthermore, should pregnancy and/or birth result, all Parties and the Child will be subject to all medical risks associated with unassisted pregnancy and childbirth as well as any additional known and unknown medical risks which occur with the use of embryo transfer. Each Party also understands that the psychological and emotional ramifications of this embryo transfer sperm donation arrangement may not be entirely predictable and there may be known and unknown psychosocial risks to the Child, all Parties, and to their children. Each Party acknowledges that there are also risks connected to this arrangement, including but not limited to, the possibility that the terms of this Agreement, in whole or in part, may not be enforced by a court of law or a Party may not fulfill his or her obligations.

Each Party represents that he or she has consulted with medical, legal and mental health professionals, and has become informed about the potential medical, legal, and psychological risks inherent in this arrangement. Each Party further represents that he or she is knowingly assuming all such medical, legal and psychological risks, and agrees, except for the obligations provided for herein, to hold harmless any other Party to this Agreement in the event of any adverse medical, legal, or psychological outcomes which result in harm, loss, or injury to the Child, the Parties, their children, or their families as a result of participation in this sperm donation embryo transfer arrangement between the Intended Sperm Donor and Intended Parents.

All Parties also acknowledge that during a pregnancy, childbirth and/or delivery that results from this arrangement, the same complications that can occur with a child is conceived by unassisted conception may occur. Therefore, it is possible that the child could be born prematurely, have congenital abnormalities, suffer from, or be a carrier of, a genetic disorder(s), or possess any of the other problems or disabilities of children conceived through unassisted conception. In addition, there may be other risks to the Intended Mother or to the Child that are related to the IVF-ET sperm donation process, including but not limited to, risks related to the gestation or birth of multiple Children, risks of premature delivery and the complications often associated with low birth weight, or risks from transmission of sexually transmitted diseases. The Parties each agree to assume responsibility for inquiring about all medical risks from their Physician. Each Party represents that he or she understands to is or her satisfaction information regarding risks associated with IVF-ET utilizing donated sperm and agrees to hold all other Parties harmless for the same.

Each Party understands and agrees that the outcome of any embryo transfer attempt is uncertain, and further understands that should conception or pregnancy occur as a result of this arrangement, a successful birth is not certain. As a result, all Parties agree that no guarantee that this arrangement will result in a pregnancy or the birth of a healthy Child has been or can be made. Knowing the risks inherent in this arrangement, each Party agrees to assume responsibility for all risks associated with participation, and to hold every other Party to this Agreement harmless, in the event of illness, death, permanent or temporary disability, psychological distress, financial loss, or any other injury to the Child, any other party, their children, or other family members. Each Party agrees to waive all potential causes of action he or she might otherwise have against any other Party to this Agreement related to this arrangement except for his or her right to enforce the terms herein.

17. DISPUTE RESOLUTION

 

All Parties agree that the health, security, and welfare of the Child are of primary concern. Therefore, each of them agrees to make every reasonable effort to resolve any disputes that may arise in the course of this arrangement promptly by participating cooperatively in psychological counseling and/or mediation. All Parties agree that any controversy or claim out of or relating to this Agreement or the beach thereof shall be referred to mediation before and as a condition precedent to the initiation of any adjudication including arbitration. If the Parties are unable to mutually agree on a mediator within thirty (30) days of the commencement of a dispute, then any Party may request that the Center for Conflict Resolution in ___________, select a candidate. The cost of any proceeding conducted hereunder shall be shared equally by the Parties unless otherwise determined by the mediator.

18. CONFIDENTIALITY AND FUTURE CONTACT

 

All Parties are in Agreement that they intend this sperm donation agreement to be known by their family, close friends, and professional advisors. It is the Intended Parents’ current intent to tell a child about the role of this Sperm Donor in this conception of the Child. Nevertheless, all Parties agree that any decision as to when and how to tell the Child about his or her genetic background shall be determined solely by the Intended Parents with the best interests of the Child as their focus. Intended Parents agree to inform the Sperm Donor when they tell the Child of his of her genetic background within 30 days of making such disclosure to the Child. All Parties currently intend that will be allowed to have contact with the Child. The terms and frequency of such contact shall be determined by Intended Parents. In spite of their intent that this sperm donation arrangement be open, all Parties agree not to discuss the sperm donation arrangement with any member of the media, or in any public format including the internet with the express written consent of all other Parties.

19. TERMINATION AND DURATION OF THE AGREEMENT

 

This Agreement may be terminated at the option of any Party upon written notice to the other Party, pursuant to Section 21, at any time prior to the combining of the Intended Mother’s eggs with Intended Sperm Donor’s sperm. Upon such termination, no Party shall be under any further obligations under this Agreement except for those obligations described in Sections 5 through 23. Notwithstanding the foregoing, after the eggs are retrieved from the Intended Mother and combined with the Intended Sperm Donor’s sperm, this Agreement shall continue in force and may not be terminated by any Party under any circumstances, unless all Parties agree in writing to such termination pursuant to the terms of Section 21 of this Agreement.

If a Child is conceived as the result of the sperm donation arrangement, this Agreement shall continue in force throughout the life of the Child, the Sperm Donor, Intended Mother, or Intended Father whichever is latest.

20. COMPETENCE AND VOLUNTARY EXECUTION OF THE AGREEMENT

 

Each Party represents that he or she is over the age of twenty-one (21), and to the best of his/her knowledge is of sound mind, and is psychologically and legally competent to enter into this Agreement. Furthermore, each Party acknowledges that he or she has fully read this Agreement, has been given opportunities to have all his or her questions satisfactorily answered, and that he or she is signing it freely and voluntarily. Each Party has relied on the representations set forth in this Agreement and represents that he or she understands the medical, legal, and psychological ramifications of this Agreement, or that he or she has entered into this Agreement freely and voluntarily.

21. MODIFICATION/COUNTERPARTS

 

This Agreement sets forth the entire agreement between the Intended Parents and Intended Sperm Donor. All agreements, covenants, representations and warrants, express and implied, oral and written, of the Parties are contained herein. All conversation, negotiations, agreement, representations, covenants, and warranties with respect to the subject herein are waived and superseded hereby. Any modification or subsequent agreement must be in writing and signed by all Parties. This Agreement may be executed in counterparts, each of which shall be an original, but all of which shall constitute one and the same instrument.

22. NOTICE

 

All notices shall be given in writing by registered or certified mail, or by messenger, subject to confirmation of receipt, to the Parties with copies to the Parties’ attorneys at the addresses listed below or at such other address as provided. The day of receipt shall be deemed the day of notice unless receipt falls on a weekend, legal holiday, or after 5 p.m., in which case notice will be deemed given the next business day.

A. Notices due the Intended Mother shall be sent to:

and to ___________

Law Offices of ___________

B. Notices due the Intended Sperm Donor:

and to ___________

Law Offices of ___________

Or to such other addresses as the Parties may provide:

23. GOVERNING LAW

 

This Agreement has been drafted, negotiated, and executed in ___________, and the Parties agree that it shall be governed by and enforced in accordance with the laws of the State of ___________. All Parties agree to submit to the jurisdiction of the ___________ courts for resolution of any disputes pertaining to this Agreement and agree that venue shall be in a Court of appropriate jurisdiction for the County of ___________.

24. ENFORCEABILITY OF AGREEMENT

 

The Parties have entered into this Agreement with the expectation that this Agreement is legally enforceable in accordance with its terms. In the event, however, that any of the provisions of this Agreement are deemed to be invalid or legally unenforceable, the Parties nonetheless agree that this Agreement represents their agreement in fact and that each of them desires and agrees to be bound by its terms. The terms of this Agreement are to be construed as evidence of the intentions of the Parties, and as such should guide the legal determination of the Parties’ respective rights and obligations. Any provision found to be invalid shall be deemed severable from the remainder of this Agreement and shall not cause the invalidity or unenforceability of the remainder of this Agreement. If such provisions shall be deemed invalid due to its scope or breadth, then said provisions shall be deemed valid to the extent of the scope or breadth permitted by law.

The Parties expressly agree that to the extent that there is any conflict between the terms any other forms of consent executed by any of the Parties and this Agreement, the terms of this Agreement shall override and replace the terms of those consent forms as to the rights and obligations of the Parties with respect to each other and to the Child.

25. BINDING AGREEMENT

 

This Agreement is binding on the undersigned, their heirs, representatives, successors, executors, administrators, and assigns. Each Party represents and warrants that he or she has read this Agreement in its entirety, understands its terms, and agrees to be bound thereby.

 

ACCEPTED AND AGREED:

 

__________________________________ ________________________________

(Intended Mother’s printed name) (Date)

 

__________________________________ ________________________________

(Intended Mother’s signature) (Social Security Number)

 

__________________________________ ________________________________

(Signature of Witness) (Date)

 

__________________________________ ________________________________

(Signature of Witness) (Date)

__________________________________ ________________________________

(Signature of Witness) (Date)

 

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