FOR THE GESTATIONAL SURROGATES:
A STEP-BY-STEP EXPLANATION
Thank you for your interest in becoming a Gestational Surrogate. Beyond fulfilling a person or couple's dream of a family, you are giving someone a future. Although you will receive financial compensation, you'll also be rewarded in other unexpected ways. In fact, surrogacy is emotionally rewarding for both the Gestational Surrogate (GS) and the Intended Parents (IPs). (BTW, get used to lots of abbreviations! Everyone uses them in this world.)
You undoubtedly have many questions about the surrogacy process, and that's a good instinct! Although surrogacy is simple in theory -- a woman carries a baby for someone else who can't -- in reality it is a complex process with many interconnected elements. In the following paragraphs we are going to give a fairly detailed description of what you'll be going through. If you want to know more, or if you have special concerns, please do not hesitate to call or email. Questions are welcome and we will always be honest and straightforward with you.
JOINING THE AGENCY
The first step is to see if you're qualified. We work only with women who fulfill these criteria:
Although many generous women want to become Surrogates, we are currently only able to work with those who live in states that unambiguously recognize the validity of and uphold the intent of the surrogacy contract. The laws in some states are less clear, so please email if you are unsure about the state you live in. Unfortunately, at this time we cannot currently consider people who reside in Arizona, Washington, New York, Kansas, Indiana, Delaware, North Dakota, Michigan or Washington DC.
While other states may have good laws we currently have the most requests for Gestational Surrogates in California, Texas, Maryland, Illinois, New Jersey and Massachusetts.
Additionally, please think carefully about your ability and willingness to be pregnant and to commit a minimum of a year of your life to helping your Intended Parents have a baby. Although the surrogacy process is immensely rewarding, it is also an intense, challenging and emotional journey; not just for you but for your family as well.
TYPES OF SURROGACY
There are two general types of Surrogate Mothers -- Gestational Surrogates (GS) and Traditional Surrogates (TS). Each has some variations:
1. Gestational Surrogate (GS) or Gestational Carrier (GC)
In this process, the Gestational Surrogate becomes pregnant through In Vitro Fertilization (IVF), using the eggs from the Intended Mother (IM). The Gestational Surrogate receives the fertilized egg through an Embryo Transfer (ET), a quick, painless procedure. The Gestational Surrogate has no genetic relationship to the baby. This is currently the most popular form of surrogacy.
A variation on this is Gestational Surrogacy with Egg Donation (GS/ED). Sometimes the Gestational Surrogate becomes pregnant through IVF using eggs from an Egg Donor (ED) other than the Intended Mother or the Gestational Surrogate. An Egg Donor is used when the Intended Mother cannot produce the eggs to get pregnant. The sperm can be provided either by the Intended Father (IF) or a Sperm Donor (SD). Again, the Gestational Surrogate has no genetic link to the baby. This form of surrogacy is growing in popularity as replacement for Traditional Surrogacy.
NOTE: Agency for Surrogacy Solutions, Inc. only handles Gestational Surrogacies at this time.
2. Traditional Surrogate (TS)
In this arrangement, the Surrogate Mother becomes pregnant through artificial insemination (AI) using her own eggs and thus has a genetic link to the baby. The sperm may be supplied by the Intended Father or another donor. Although Traditional Surrogacy is still used, it is not as common as it was even a few years ago.
ARE YOU A GOOD CANDIDATE?
Please click on the following link and fill out the short questionnaire to determine if you'd make a good Gestational Surrogate candidate. We'll get back to you promptly with our response!
GESTATIONAL SURROGATES CLICK HERE TO FILL OUT A SCREENING QUESTIONNAIRE
APPLYING TO WORK WITH OUR AGENCY
If you pass the initial screening, we will ask you to fill out a much longer questionnaire, which covers a broad range of subjects so that we, and eventually potential Intended Parents, can get to know you. This questionnaire should take roughly 30 minutes to complete. We prefer to send and receive the questionnaire by e-mail.
We will also need photographs of you and your family. It's easiest if the photographs are digital format and are sent through the Internet. If you do not have a digital camera, your local photo shop can create them from prints or you can mail the prints directly to us for scanning.
After you return your questionnaire, one of our Surrogate Coordinators will conduct a phone interview with you. This is not meant to be intimidating it's just a more direct way to get to know each other and answer any questions you may have. Then, one of our directors will also call to talk to you.
Once we agree to work together, you should download the Agency Program Agreement document, which you will need to print out, sign, and fax/mail to our office.
This indicates your willingness to become a Gestational Surrogate with our agency. It also gives the Intended Parents permission to review your questionnaire and photographs. (Agency for Surrogacy Solutions always insures that your privacy is protected. The Intended Parents will not see the page of the questionnaire that contains confidential identifying information. Your last name and identifying information will not be revealed to any Intended Parents until all agree to work together.)
GATHERING YOUR INFORMATION
At this time, you will be asked to start collecting your medical and insurance information. You will need to get copies of your previous OB/GYN records. Most importantly your most recent obstetric records including your most recent Pap smear.
You will also need to get us a copy of your health insurance policy (if you have one.) If you don't have a copy at home you will need to call the insurance policy administrator and ask for the EOC (Evidence of Coverage) that should include all exclusions in your policy. We review this to determine not only if you have maternity coverage but to see if it will also cover a surrogacy pregnancy. Many policies do not. We will need a copy of your complete policy for our files.
BEING SELECTED
Matching IPs and GSs with the right people is an extremely personal process. Intended Parents typically look for someone healthy and stable, but they also want someone with whom they believe they can comfortably work with during the close, emotional process of a Surrogacy pregnancy. The agency can't guarantee when you will be selected. You could be chosen in one week, one month, or longer from the time you complete your application.
Once we think we have a good match for you we will contact you and send you the IP's questionnaire and pictures. This will help you get to know them and to see if they feel like a good "match" for you. You will be able to ask additional questions after reading their profile.
INTRODUCTIONS
If you like what you've learned and the IPs feel the same way after reviewing your questionnaire (without your private information), we'll schedule a meeting or conference call with the agency, the Intended Parents, you and your partner (if you have one) and the agency Case Manager who will also be working with you. If the conference call is successful and you, your partner and the Intended Parents are interested in working together, you will move onto the medical and psychological evaluation phase. A background check will also be run by a professional service at this time. (Don't be intimidated. It's standard practice in the surrogacy world.)
PSYCHOLOGICAL SCREENING
Once you and your IPs have agreed to work together, you will meet with a licensed psychologist to assess your mental and emotional readiness for the surrogacy process. Once more, don't worry. Most Surrogates find the meeting to be both helpful and informative. In most cases, you will meet for an hour with the therapist to discuss your feelings about surrogacy, your motivations and your support system. The IPs will also meet with you all together, if they are able. The therapist will also have you fill out an MMPI (a personality inventory), which can take up to another hour. All of this is to ensure that you understand the commitment being a surrogate takes and that you are emotionally prepared to proceed. The Intended Parents will pay for the psychological screening.
MEDICAL SCREENING
Both you and your partner (if you have one) will need to be medically evaluated. Your testing will usually be done at the Intended Parent's fertility clinic. This may require traveling for you if you do not live near the clinic. Travel will be arranged by the agency and paid for by the IPs. Your partner will only need to have blood work done to screen for sexually transmitted diseases (STDs) and HIV, but you'll have additional blood tests and a gynecological exam. The reproductive specialist or Reproductive Endocrinologist (RE) will determine if other tests are necessary. They usually aren't. Even if your partner cannot attend the medical screening, he will need to have his blood work done. The medical screening is paid for by the Intended Parents.
TRAVEL
If your IP's clinic is not near your home, you may have to travel. If so, the Intended Parents and/or the agency will make your travel arrangements and the Intended Parents will pay for the costs. If the IP's clinic is not nearby, we can arrange for medical monitoring to be done near your home. In these cases, the Gestational Surrogate usually only has to travel for the initial medical evaluation and at the time of the Embryo Transfer.
COMPENSATION AND CONTRACT NEGOTIATIONS
The surrogacy arrangement ensures that the Gestational Surrogate will not spend any of her own money for the IVF-related procedures or the subsequent pregnancy. The Intended Parents are responsible for all expenses such as medical procedures, doctor's fees, medications, attorney's fees, phone calls, etc. Click here for Surrogate Benefit information.
Once we have worked out the particulars of your surrogacy, your Intended Parents will have their lawyer draw up a contract. The contract will then be forwarded to your lawyer by the IPs lawyer. (Note that the contract is between you and the Intended parents and does not involve the agency.) You will then consult (most often via phone) with your lawyer, who will review the contract with you, suggest additions or alterations, negotiate any other changes and review the revised version before you sign it. Although you can choose your own attorney, the agency will provide you with lawyers who are knowledgeable about reproductive law in the state in which you will give birth. Attorney fees are paid by the Intended Parents.
PAYMENTS
The Intended Parents will also open an Escrow account, into which they will place the funds for the surrogacy before the Embryo Transfer. Based on what is negotiated in your contract, the agency will trigger once a month payments, which will be sent on time and you won't have to remind anyone to send them. Even if something were to happen to your IPs, you would still be compensated, since the funds are already set aside. In that unfortunate event, you won't have to worry about what will happen to the baby(ies) you are carrying; the IPs will have designated a guardian.
GETTING PREGNANT
The medical procedure for the Embryo Transfer (ET) to the Gestational Surrogate (GS) is similar to having a Pap smear. In most cases it's pain-free. First, your menstrual cycle and the menstrual cycle of the Intended Mother (IM) or Egg Donor (ED) are synchronized using birth control pills and daily injections of Lupron, a drug that suppresses ovulation. If it seems scary, don't worry! Everyone who has been through the process feels intimidated at first. Often after the first few days they're amazed at how simple and relatively painless it is. The nurse at the reproductive clinic will talk you through the first injections, and we can always help you, too. You will also be taking Estrogen before the transfer, and the Intended Mother or Egg Donor (ED) will be taking daily injections of fertility drugs.
During this time, the development of the Intended Mother or ED's eggs is monitored by periodic blood work and ultrasounds. At the same time, the thickness of the lining of your uterus, which is crucial to the success of the Embryo Transfer, will be evaluated using blood tests and transvaginal ultrasounds. You can expect to visit the Reproductive Endocrinologist a few times before the Embryo Transfer in order to check your uterine lining for its readiness to receive the embryo. That exam is entirely painless. Three to five days after the eggs have been retrieved from the biological Mother (or Egg Donor) and fertilized with the sperm of the biological father (or Sperm Donor), the physician will transfer the embryos to you. As we've noted, that procedure is something like a Pap smear, and it's completed under sterile conditions. Depending on the physician, you may then begin progesterone injections and/or suppositories.
Many clinics require a period of bed rest after the Embryo Transfer. That can range from 12 to 72 hours. The Intended Parents will expect you treat the doctor's instructions seriously. If you need childcare to allow you to stay in bed, that will be provided as specified in your contract. Your contract will cover all such eventualities, so you will never have to worry about money to meet your surrogacy obligations. About 10 to 12 days after the embryo transfer, you'll get a pregnancy test. This will usually be done by drawing blood at the clinic or local lab.
THE PREGNANCY
You and your IPs will together determine how much contact you will have during the pregnancy. If you both want a lot of contact, you can arrange for frequent visits or phone calls. If you live far from each other, or if it's your mutual wish, you may just see them for some doctors' appointments and/or correspond through e-mail. If ever there are questions, changes or problems, we will be there to help resolve them. We encourage healthy and respectful relationships between the Intended Parents and Surrogate. We are committed to doing our best to make the experience rewarding for all, and believe that communication is a key factor in a good surrogacy relationship.
Our role during your surrogacy is to give you all the support you need. We want to be there for you but we don't want to smother you either. You will have a Case Manager who will help with all of the logistics from travel to payments and a Surrogate Coordinator. The Surrogate Coordinator is an someone you can speak with as a peer -- she's an experienced GS and can often offer you insight and advice that we, as former IPs, just don't know. Our agency also offers an online chat group to share your experiences, ask questions of, offer support and become friends with other Surrogates. This chat room is solely for Gestational Surrogates who are working with our agency.
AGENCY CONTACT
You probably would like to know how much contact you will have with our agency. The answer is, as much or as little as you want. You will deal directly with either Kathryn or Lauri, the agency Co-Directors, your Case Manager and one of our Surrogacy Coordinators throughout the arrangement from the time you are accepted into the program until after the birth of the baby. We will always be there to answer any questions or concerns that arise.
ADDITIONAL BONUS
If you know of a wonderful someone who may want to be a Gestational Surrogate and lives in a "Surrogate friendly" state, please refer her to info@agency4solutions.com. To show our appreciation, we offer a bonus of $250 when your referral is matched and she signs a contract with her Intended Parents. We realize that you probably don't expect any compensation for assisting others fulfill their desire to help an infertile couple, but it is our way of thanking you for helping.
Let us emphasize once more that being a Gestational Surrogate can be one of the most rewarding experiences of your life. We would be honored if you let us be a part of your miraculous journey.