10 steps to becoming a Gestational Surrogate
10 Simple Steps to Surrogacy for the Gestational Surrogate
- Step 1. Being Matched
- Matching IPs and GSs 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.
- Step 2. 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 everyone wants to move forward, we will move onto the medical and psychological evaluation phase. Our agency will help coordinate all of this. If we have not already done so, 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.)
- Step 3. Psychological Screening
- Once matched, 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 talk for an hour with the therapist to discuss your feelings about surrogacy, your motivations and your support system. The IPs may also talk with the therapist. The therapist will also have you fill out an MMPI or PAI (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.
- Step 4. Medical Screening
- You and your partner’s (if you have one) 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 – which is most often the case. 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 cultures, and a gynecological exam. The reproductive specialist or Reproductive Endocrinologist (RE) will determine if other tests are necessary. Even if your partner cannot attend the medical screening, he will need to have his blood work done at a lab near to his home or work. The medical screening is paid for by the Intended Parents.
- Step 5. 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 (ET).
- Step 6. Compensation and Contract Negotiations
- The surrogacy arrangement ensures that the Gestational Surrogate will not be out 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. 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.
- Step 7. Payments
- The Intended Parents will also open an Escrow (also referred to as a Trust) 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 — you won’t have to remind anyone to send them.
- Step 8. 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 trans-vaginal 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 a few 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.
- Step 9. The Pregnancy
- You and your IPs will together determine how much contact you will have during the pregnancy. When matching, we try to take each of your desires into consideration. 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 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.
- Step 10. 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 be in contact 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.