Surrogacy: Understanding the Process

Surrogacy is a powerful decision made by couples or individuals who long to have children but are unable to carry a pregnancy themselves. Surrogacy is a beautiful way to bring a child into the world and to fulfill a dream of parenthood. However, the surrogacy process also requires understanding and openness. In this blog post, we’ll walk you through the journey of surrogacy, from what it entails, to how to know if it’s right for you, and how to find the right surrogate for your unique situation.

What is Surrogacy?

Surrogacy is an arrangement in which a person carries a baby to term for those who cannot or wish to not conceive or carry a baby to term on their own. Surrogacy can be achieved through artificial insemination or in-vitro fertilization (IVF), where embryos are created in a laboratory setting and implanted into the surrogate’s uterus. The surrogate becomes pregnant and carries the baby to term, before giving birth and relinguishing the child to the intended parents.

Understanding the Different Types of Surrogacy

There are two types of surrogacy. The first type is traditional surrogacy, where the surrogate uses her own eggs and is therefore biologically related to the child. The second type is gestational surrogacy, where the surrogate carries an embryo created through IVF using the intended parents’ or donors’ eggs and sperm, which means they have no biological link to the child. Nearly all surrogacies in the US are gestational surrogacies.

The Surrogacy Process

Like any road to parenthood, surrogacy is rarely a straightforward process. Below you will find the general steps to the surrogacy process, which may vary slightly from agency to agency or per your family or surrogate’s unique situation. The surrogacy timeline varies widely and is not a process that can be rushed. Any of the following steps might take a few tries before being able to move forward with the surrogacy process.

1. Gathering Information: The first step to the surrogacy process is to research your options. If you’re reading this blog post, this is likely where you’re at! Thoroughly understanding the ins and outs of the surrogacy process is a crucial first step for intended parents. You’ll want to be sure that surrogacy is the right path to parenthood for you, as opposed to other options such as adoption. You also want to ensure that you’re emotionally and financially ready for parenthood through surrogacy.
2. Reach Out to a Surrogacy Agency: Most intended parents start the search for a surrogate through an agency. This typically involves an application and consultation where you can speak with surrogacy placement specialists and ensure that the arrangement will be a good fit for your family. You may choose to reach out to multiple agencies so that you can find which agency feels best for your unique situation.
3. Match with surrogate: Next, the intended parent(s) will be ready to select a surrogate. If you’re using a surrogacy agency, you will likely browse pre-selected profiles of potential surrogates before interviewing them. Depending on location, you’ll have a meeting either in person or over video to start to get to know one another. The decision to work together is a mutual one between intended parents and surrogates.
4. Legal matters: Surrogacy laws vary by location. However generally speaking, separate licensed, legal representation is required for both the intended parent(s) and the surrogate. This is important in order to protect all parties’ best interests. After legal documents are drafted, reviewed, and signed, this is an appropriate time to set up an escrow account to hold your funds allocated for the surrogacy process.
5. Surrogacy screening process: Surrogates must be medically screened to ensure they’re healthy to carry a pregnancy. The suggogacy screening process includes lad work such as blood tests, physical and psychosocial exams, criminal background history check, and a general consultation with the health care team. Typically, intended parents must also undergo screening such as a psychosocial exam and criminal background checks.
6. Health insurance for the baby: Next, intended parents purchase health insurance for their baby (or babies!), or plan to pay out of pocket for their baby’s medical care. Surrogates must typically carry their own health insurance, but it will only cover her medical costs directly. Some agreements ask that parents contribute to the surrogate’s health care costs.
7. Surrogacy contracts: At this stage, it’s time for contracts to be signed. With both parties having undergone through consultations, background screening, and legal preparations, a surrogacy agreement can be signed. This is essential before proceeding to any of the following steps. Often, some level of payment is required from the intended parents to the surrogacy agency or surrogate directly, to secure the contracts.
8. Surrogacy IVF: Now it’s time to start the embryo transfer process! The intended parent(s) create embryos through in vitro fertilization (IVF), using either their own and/or donor eggs and sperm. The surrogate prepares for the process with medications to create an ideal hormonal environment for surrogacy embryo transfer. This process can take anywhere from several weeks, to many months.
9. hCG test: Roughly two weeks after the surrogacy embryo transfer is complete, it’s time to test for pregnancy. The surrogate will undergo blood and/or urine testing to confirm pregnancy and check for hormonal level increases in the blood, suggesting a successful embryo transfer.
10. Release to OB/GYN care: Once the pregnancy has been confirmed additionally by ultrasound in the first trimester, the surrogate will transfer care from the fertility clinic to regular OB/GYN or midwifery care. Depending on location and surrogacy agreements, you may either attend some prenatal visits, or none at all.
11. Surrogacy Parental Establishment Judgement: Around the pregnancy age of viability (around 24 weeks), it’s time for intended parents to legally establish parental judgement. After this legal arrangement is established, all decisions about the baby or babies’ care now falls to the intended parents.
12. Surrogacy birth process: Now, it’s time to wait for your baby to grow to term! When it’s time for the surrogate to give birth, either spontaneously or via planned induction or Cesarean, the Intended parents may attend the birth if desired by all parties. Additionally, per prior agreement, the surrogate may or may not express breastmilk for the baby or babies, depending on mutually agreed-upon preferences.
13. Surrogacy birth certificate: Soon after the birth, the intended parents will sign their baby’s birth certificate and be officially named as their legal parents.
14. New parenthood: At long last, your dream of parenthood has arrived. New parenthood after surrogacy is an emotional rollercoaster. Planning a nurturing support system for your newly expanded family is a wise idea.

Surrogacy Process: Start to Finish

The surrogacy journey is meant to be a rewarding and fulfilling one. However, it is not without its challenges and trials. Surrogacy is a process that, like parenthood, requires patience, flexibility, and steadfastness every step of the way. However, it’s also okay to begin the surrogacy research process, and decide that surrogacy isn’t right for your family. Trust your instincts, and know that it’s okay to take your time when choosing surrogacy or an alternative.