The Surrogacy Process at a glance for a surrogate
So this is how it typically works when a surrogate goes through this experience.
- Surrogate Screening
- Medical Screening
- IVF Cycle
- Legal Wrap Up
I’ll break down each phase a bit more.
When you’re interested in being a surrogate, your first step is to research the process. Which is what you’re doing now! Great! You want to figure out how this whole thing works, think about special considerations like how do you feel about terminating a pregnancy for complications, how many embryos would you want to transfer (1 or 2), and how will my family/friends feel about this? Research is honestly the most important part to surrogacy. Fully understanding what you are getting into and all of the different nuances to surrogacy is important.
I remember some of the things I used to think back in the beginning of surrogacy. There are some things that I’ve completely changed my mind about. Others, I understand much more intimately than I did when I first considered this.
How should you research? Read, read, read. Read blogs. Read facebook group posts. Read anything you can get your hands on. If you want to get into Facebook groups, just type surrogacy and surrogate into the search bar and a bunch will pop-up. Word of caution, lurk first before posting. You will learn a lot by just watching.
The next step is to apply to the agency of your choice. There are many great agencies and just as many bad ones. Research this too before you start applying. Some of the biggest differences between the good agencies is how much hands-on do you want them to be? The agency I work with is very hands-on. They handle everything for you and it’s amazing. I didn’t realize how amazing it was though and switched to a more hands-off agency without realizing it. I did not enjoy that experience.
If you are not going through an agency and decided to do an indy journey, then this step doesn’t apply to you.
The screening process with an agency can take months. You will fill out an application that asks all about you. You’ll give them proof of identity, income, insurance information, medical records, pictures of you and your family for your profile, complete an interview, do psychological testing (a personality test and an interview with a mental health professional) and anything else they want you to do. This is to make sure you fully meet all of the qualifications and to prepare for the surrogacy experience ahead. A lot of this information is used by the agency later on to create your matching profile, provide to the fertility clinic and to walk you through the pregnancy. This part can feel pretty invasive at first, but get used to it because that’s par for the course in surrogacy and it’s necessary.
If you are going independently, a lot of this will happen after matching with the fertility clinic.
Now here’s the best part! Finding Intended Parents to work with! Finding a good match is so important! Your agency will create a profile for you and then work to find you someone that meets your preferences. Most agencies have a waiting list of Intended Parents because unfortunately, there are more Intended Parents than there are Surrogates. So they’ll look through their list and find someone they thing will be a good fit. They’ll either send you the profile of the IPs first and you’ll get a chance to read about them and make a preliminary decision on whether you want to have a conversation. Or they’ll send your profile to the IPs first and let them make the first decision. Either way, each agency has their own method to this and what it comes down is to a mutual decision. You’ll keep going until you both say yes.
Now once you say yes, usually the next step is to meet. This is either face-to-face (if possible) or by video. During this, you’ll have a chance to get to know each other better and ask questions and make a decision if it feels like a good fit. Again, it’s mutual. You’ll both have to decide it’s a good fit.
Once you both agree, you’ve found your match! From here, you’ll work on getting to know each other better. It can be so fun!
After matching with Intended Parents, you will each get a lawyer. This cost is covered by the IPs. Your agency will often give you a list of experienced surrogacy lawyers to help you choose from.
The IPs lawyer will draw up a contract which will cover everything during the surrogacy experience from who’s responsible for what costs, to any restrictions you will have, plus outline anything else necessary. The contract will be sent to your lawyer and you will go over it line by line with them. It’s so important to understand and agree with everything. If you don’t agree to something, ask for it to be changed. Then all requested changes will be sent back to the IPs lawyer. This process will continue back and forth until everything is agreed upon. Again, I can’t stress enough how important it is to comfortably agree. Do not just agree to end it. Make sure you are comfortable with every single line of the contract. You will be living by this contract for at least the next year of your life and it will impact practically every aspect of your life.
Next you will do medical screening with the fertility clinic that the Intended Parents have chosen. Often, they have already been working with this clinic for awhile and so it’s unlikely that it will be in the same state as you (because they didn’t know where their surrogate would be located, they usually choose a clinic long before getting matched). Each fertility clinic will have their own protocol for medical screening. Either way, you will go through tests to make sure you meet their requirements. These are often blood test, urine tests, and ultrasounds. It can be more or less. You’ll have a nurse assigned to you who will walk you through what you need to do. Sometimes you will need to travel to the clinic for the medical screening. (The travel costs are covered by the IPs). When this happens, you are usually only gone for a day and complete the screening then head back home.
IVF Cycle or Medication Protocol
Once you have completed the screening, you will begin the medication protocol. Again, this is different for each clinic/doctor. They will send a box of medications to your home and give you instructions on what medications to take and when. It’s really important to understand and follow this part to a T. It will often include a combination of oral medications and injections, sometimes suppositories. The medications are to increase your chances of getting pregnant (to put it simply).
The Reproductive Endocrinologist (RE) will determine when you will do the embryo transfer based on how your body is responding to the medications. Transfer day is one of the most exciting parts of surrogacy. You will again travel to the clinic and complete the transfer. They will take the embryo and place it in your uterus with a thin catheter. This is quick and painless, usually less than a 15 minute procedure. Although you will be at the clinic for longer than that to prepare. Some REs will have bed rest after as part of their protocol. This can range from 1-3 days. Then you’ll fly home.
Now here’s the hard part: the dreaded 2 week wait (2ww). This is the time between when you did the transfer and finding out if you are pregnant. Ohhhh the agony. : ) Everyone wants to know if the embryo implanted and you are pregnant. Some surrogates will choose to use at home pregnancy tests (pee-on-a-stick/POAS). The RE will order a blood test 14 days after the transfer day to find out if you are pregnant. The blood test will give you a beta level number. Often this number is anywhere from 30-300. A few days later, the doctor will request another beta level blood test. They will be looking to see if the original number has at least doubled. If it did, that’s a good sign! And from there on, there’s often more blood tests to keep watching the numbers until the RE orders an ultrasound. This all varies as well. I’ve had REs order only 3 blood tests and then the ultrasound and another RE order a weekly, sometimes bi-weekly blood test, plus weekly ultrasounds. Woof, that one was a lot of work.
So assuming you got pregnant, now you go through the pregnancy following the contract. You will see an OB local to you and the Intended Parents usually like to be involved by asking questions, attending appointments either in person or via video, etc. It’s such an awesome experience to go through a pregnancy like this because you get to be involved and excited for someone else.
A lot of people want to know how the delivery goes. You will deliver at the hospital local to you and the Intended Parents will come to you. It’s not common nor advised for you to go the parents. During contracts, you will often have worked out the details of how delivery will go. Such as will the parents be in the room (common), who holds the baby first (often the parents), medication preferences, etc.
I will never forget my first surrogate delivery. Watching the Intended Parents transform into parents was life-changing. I could see a literal physical transformation in them the second their daughter was born. While it was hard work, it really was an honor to get to be a part of that and I hope you get the same experience. Delivery day is amazing.
After the baby is born, you will wrap up the experience by establishing parentage. Now this process will vary state-to-state as some states have laws on surrogacy and some don’t. Either way, the parents will be the ones who end up on the birth certificate. Their lawyer will walk you through anything that you need to do.
Once It’s All Over
Now this is an interesting part of surrogacy. For the last 18 months to several years, you have been working on this surrogacy experience from research to saying goodbye to the family. Once it’s all over, many surrogates will experience a “what now” feeling. This is perfectly normal. It’s been an exciting experience and we’ve usually gotten really close with the parents. It’s perfectly normal and expected that their focus will shift to their new baby. For the surrogate, you are often excited to get back to “normal” life but you might also feel a little loss. My recommendation is to just be gentle with yourself during this time if you do feel a little loss. Make some fun plans and find things to look forward to, reach out to friends or pick up a new hobby.
Many times, IPs and the surrogate remain in contact after the baby is born. This will just depend on how things have developed. Some of my friends have even gone to visit their IPs and baby. Surrogacy builds beautiful relationships.
So there you have it. That’s the surrogacy process in a nutshell from the surrogate’s perspective.
Any Questions? Reach Out!
I’m happy to answer any questions you have about any of this.