All journeys are different, in life, as well as in surrogacy. Each one has unique challenges and varied levels of friendship, hope and promise. As a first time surrogate, everything is new, exciting and filled with a little trepidation. Having a good sense of the steps of surrogacy can help ease that feeling of uneasiness and allow you to enjoy the ride.
Beginning the journey starts far before you meet your intended parent(s). Surrogates typically do a lot of research that allows them to follow surrogate stories and gives them a general idea about the surrogacy process. It also allows surrogates to find an agency they feel comfortable with. Agencies are a key piece of support throughout your journey. Finding an agency you trust, and getting to know your agency, is the first step on your path to surrogacy.
After choosing your agency and asking pertinent questions regarding compensation, time commitment, access to current surrogates and clinics they work with, it is time to get your pregnancy records. All surrogates have been through pregnancy and have a history of healthy, full term pregnancy(ies). In order to show the Reproductive Endocrinologist (IVF Doctor/clinic) this history, your agency must have pregnancy records. You can start by calling your OB/GYN who delivered your babies and requesting your records. They can usually be mailed or emailed to you or the clinic. A medical release, signed by you, will be required by the clinic.
Most agencies want to know their surrogates well. Agencies will set up an in home visit or video call to explain the surrogate process and to get to know more about you and your partner (if you have one). Having the support from a current partner is essential as he/she will be a huge part of your support network. Your partner will also need to be medically and mentally evaluated .
Your agency will perform a background check on you and your partner. In order to feel confident that surrogates are law abiding and ethical people, agencies ask that a surrogate and any partner submit to a criminal background check. Some agencies will also run credit checks. It is important to be honest and upfront with your agency regarding any legal or financial trouble you may have been in so that any past issues can be addressed at the time of the application process
After your pregnancy records have been obtained and a background check has been performed, it is time to match you with a parent or parents (intended parent) who have similar goals and expectations. If you want a close relationship with your intended parent and would like them to be able to attend doctor’s visits, an international intended parent may not be well suited for you. If you are flexible in who you are willing to carry for, then your match may be faster and easier. It is critical to be forthcoming and honest about the intended parents you would be comfortable carrying for as the match is the most important part of the process. With a strong match and a good relationship, nearly all hurdles can be overcome. A match riddled with uncertainty and angst often leads to issues throughout the journey.
Once you have viewed the profile of the intended parent and they have seen yours, a temporary match is created. Until you sign your legal contract with your intended parent, you are not legally matched but a temporary match is an incredible step in the process. A video or in person meeting is set up to discuss the expectations of the journey and connect the intended parent and surrogate for the first time. Just like a first date, everyone is usually very nervous. Nerves are good and can quickly turn to excitement when the right match is made. After the initial introduction, it is often a good idea to take some time to think about any questions you still have for your intended parent and to ask those through your agency. If you have any concerns, talk with your agency. Sometimes these are easily explained through more information and sometimes they lead to bigger discussions that ultimately lead to the decision that it is not the right match. The more you know, the more informed your decision will be.
After you are temporarily matched, you (and your partner) will attend a psychological screening with a mental health professional. The screening includes both an interview and a personality test . The mental health professional uses both the test and the interview to determine if you are a viable candidate for surrogacy. If they are comfortable with your screening, you are deemed “psychologically cleared”.
After both you and your intended parent feel comfortable with the match and your pregnancy records have been reviewed and approved by the clinic, you will be sent to the clinic to have a medical evaluation. The evaluation consists of three parts: an interview with the doctor, a blood test and an ultrasound. The interview is often short but asks that you give a detailed medical background including diseases, and a description of your pregnancies. The blood test is done to test for infectious diseases, STDs and alcohol/nicotine/drugs. The blood results are often not available for 7-14 days. The ultrasound is used to check the health of the uterus. Each piece of the three part evaluation and your pregnancy records, are assessed by the IVF Doctor and are approved. At this point you are “medically cleared”.
After medical clearance is granted, the legal process begins. Both you and your intended parent are represented by separate attorneys who represent each party’s best interest. Your agency will be able to introduce you to an attorney who specializes in the field and is capable of walking you through the process and reviewing your contract with you. The cost of the attorneys is covered by your intended parent. When the legal contract is signed and notarized by you and your intended parent, you will be deemed “legally cleared”.
Once psychological, medical and legal clearances have been granted, the clinic will give you a medication schedule and an embryo transfer date. The medication schedule needs to be followed with precision. Any changes, errors or questions should be sent to both the clinic and the agency immediately. This part of the process requires diligence and should be handled with care and responsibility. Depending on the medications administered and the clinic that is being used, there may be the need for injections. You can usually administer these on your own but often times, surrogates ask a friend or partner to aid them. The length of time you administer medications varies.
Transfers almost always occur at the clinic where the embryo was created. Often times a surrogate has to travel to this clinic for both the medical screening as well as the transfer. Transfers can be an emotional time for all parties involved and it helps to remain cautiously optimistic. Transfers do not always take the first (or second, or third) try. Following the doctor’s protocol, being diligent about your medication schedule and trying to remain relaxed lend the best results.
Surrogacy is not a journey everyone is willing or able to take. Surrogates find the most incredible and inexplicable reward when they are able to give the gift of life, and often go on to repeat the process several times over. Through the trusted bond that is created between your agency, your intended parent, your partner and yourself, surrogacy can be a process that connects and unites everyone involved. Knowing what to expect throughout your journey helps you to make informed decisions, make yourself the best possible candidate for surrogacy, and enables you to enjoy not only the journey but the incredible destination.