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Psychological Considerations in Assisted Reproduction

Deciding to use a surrogate involves a complex set of psychological considerations. This is true for both Intended Parents and for surrogates.

For Intended Parents, here are some key psychological impacts of surrogacy to consider:

Infertility and Emotional Impact:

Experiencing infertility can evoke a range of complex and intense emotions, often comparable to the grieving process. Here are various emotions that individuals or couples dealing with infertility may encounter. The initial realization of infertility can be shocking and difficult to accept. There might be disbelief or a sense of being overwhelmed by the news. Many people dealing with infertility find it  challenging to process their fertility challenges which may lead to emotional numbness and strained relationships. It’s very common for people to initially deny the reality of infertility, hoping that it’s a temporary situation or a mistake. Denial can be a coping mechanism that allows individuals to gradually accept the reality of their situation at their own pace.

Feelings of deep sadness and depression are common responses to the loss of the expected or desired ability to conceive naturally. These emotions may affect daily functioning, energy levels, and overall well-being. Infertility can lead to feelings of anger, frustration, and even resentment toward oneself, a partner, or the situation. These emotions may be directed inward or outward, causing strain in relationships and self-esteem.

Some individuals may experience guilt, believing that they are somehow responsible for the infertility. There might also be a sense of shame related to societal expectations. These feelings can be debilitating and may contribute to a negative self-image. Uncertainty about the future and fear of the unknown, including the prospect of never having children, can lead to heightened anxiety. Infertility can be isolating, as individuals may feel that others, especially those with their own children, don’t understand their pain. This sense of isolation can lead to loneliness. Seeing others achieve pregnancy or parenthood may trigger feelings of jealousy and resentment. Managing these emotions can be difficult, and they may strain relationships with friends or family members who are expecting.

Over time, some individuals may reach a stage of acceptance, finding hope and meaning in alternative paths to parenthood, such as adoption or assisted reproductive technologies including surrogacy.  



Turning to Surrogacy:

Many Intended Parents turn to surrogacy because they are dealing with infertility or the biological inability to carry. Dealing with the emotional impact of infertility, including grief and loss, is a significant consideration.

Maintaining reasonable expectations and fostering a positive relationship with a surrogate is crucial for a successful and harmonious surrogacy journey. From the beginning, establish open and honest communication with your surrogate. Discuss expectations, preferences, and potential challenges. Regular updates and open dialogue can help build trust and ensure everyone is on the same page. Clearly define roles and expectations. Discuss the level of involvement, communication preferences, and boundaries. Respect the autonomy of the surrogate, acknowledging her preferences throughout the process. Acknowledge and appreciate the emotional and physical efforts of the surrogate. Express gratitude and empathy for her role in helping you build your family.

Ensure that all legal aspects are well-understood and documented in a legally binding contract. This includes financial arrangements, responsibilities, and potential scenarios. Consider involving a counselor who specializes in surrogacy to provide emotional support.

Create an environment where the surrogate feels comfortable expressing concerns or raising questions. Address any issues promptly to prevent misunderstandings from escalating. Understand that the surrogacy journey may not always go as planned. Be flexible in adapting to unforeseen circumstances, changes in the pregnancy, or other unexpected events.

Remember that a successful surrogacy journey is built on trust, transparency, and mutual respect. By maintaining open lines of communication, clarifying expectations, and being supportive throughout the process, you contribute to a positive relationship with your surrogate, fostering an environment that benefits all parties involved.

For Surrogates, be psychologically and emotionally prepared:

Motivations for Surrogacy:

Understanding your motivations for becoming a surrogate is important. Altruistic motives, a desire to help others, and a strong support system can contribute to a positive experience.

Emotional Preparedness:

Surrogates need to be emotionally prepared for the physical and emotional challenges of a surrogacy pregnancy.  Having a strong support system, including family and friends, is crucial for surrogates. Emotional support can help them navigate the physical and emotional demands of surrogacy. Many surrogacy arrangements involve psychological counseling/clearances in advance to ensure the surrogate is mentally prepared for the journey.

Traditional surrogacy:

Traditional surrogacy, where the surrogate is biologically related to the child she carries on behalf of Intended Parents, requires extra support as the surrogate must be prepared to surrender parental claims to a child that is biological hers. Traditional surrogacy should always be explored with caution and when all parties understand the unusual dynamics involved.

Agency in Decision-Making:

Surrogates must have a say in decisions related to their health, pregnancy, and birthing process and these are critical points to discuss during matching with potential Intended Parents. Establishing clear communication and setting boundaries is crucial for a healthy surrogacy relationship. Both parties need to respect each other’s boundaries and understand the expectations for communication during and after the surrogacy journey.

The Surrogacy Psychological Screening Process

The psychological screening process for surrogacy is a crucial step to ensure that surrogates are emotionally and psychologically prepared for the complexities of the surrogacy journey. The primary goal of psychological screening is to assess the surrogate’s mental and emotional well-being. It helps ensure that the surrogate is psychologically prepared for the challenges associated with surrogacy.

Personal History Discussion:

Surrogates can expect to participate in in-depth interviews with mental health professionals. These discussions may cover personal history, relationships, and emotional experiences.

Evaluation of Mental Health:

Mental health professionals will assess the surrogate’s mental health history, including any history of depression, anxiety, or other psychological conditions.

Stability and Coping Mechanisms:

The evaluation often includes an exploration of the surrogate’s stability and her coping mechanisms for dealing with stress.

Assessment of Emotional Readiness:

The psychological screening process will gauge the surrogate’s emotional readiness for the surrogacy journey, including her understanding of the emotional challenges involved.

Understanding Motivations:

Mental health professionals will explore the surrogate’s motivations for becoming a surrogate. This helps ensure that her reasons align with the ethical and emotional aspects of surrogacy.

Evaluation of Communication Skills:

Effective communication is crucial in surrogacy. The screening process may assess the surrogate’s communication skills and her ability to express her thoughts and feelings.

Evaluation of Support System:

The mental health professionals may inquire about the surrogate’s support system, including her relationships with family and friends. A strong support network is often considered beneficial.

Discussion of Expectations:

The screening process involves a discussion about the surrogate’s expectations and understanding of the surrogacy journey. This includes expectations about the relationship with Intended Parents and the emotional aspects of pregnancy and childbirth.

It’s important for surrogates to approach the psychological screening process with honesty and openness. This process is designed not to disqualify individuals, but to ensure that they are well-prepared for the emotional and psychological aspects of surrogacy. It provides an opportunity for surrogates to discuss any concerns or questions they may have and to receive the necessary support throughout the surrogacy journey.

Surrogates should be aware that support services, including counseling, may be offered throughout the surrogacy journey to address any emotional needs that may arise.

Surrogacy and the Responsibilities of all Parties:

Both Intended Parents and surrogates should be well-informed about the medical procedures and process involved in assisted reproductive technology and surrogacy. Understanding and discussing the potential physical and emotional risks associated with surrogacy is important.

Having a clear and legally binding surrogacy agreement that outlines the rights and responsibilities of all parties involved is essential.

The decision to pursue surrogacy is deeply personal and involves a comprehensive consideration of emotional, ethical, legal, and interpersonal factors. Open communication, empathy, and a supportive environment for all parties are crucial for a positive surrogacy experience. It is often recommended that individuals and couples seeking surrogacy consult with professionals, including psychologists, counselors, and legal experts, to ensure a well-informed decision-making process.

Frequently Asked Questions: Psychological Impacts of Surrogacy

What emotional impact does infertility have on Intended Parents?

Experiencing infertility can evoke a range of emotions, including shock, disbelief, sadness, anger, guilt, and fear. It often parallels the grieving process, affecting daily functioning and relationships.

How can Intended Parents maintain a positive relationship with a surrogate?

Communication is key. Establish open communication channels, define roles and boundaries, express gratitude for the surrogate’s efforts, and be flexible in adapting to unforeseen circumstances.

What should surrogates know about psychological screening for surrogacy?

The psychological screening process aims to assess mental and emotional well-being. Surrogates can expect in-depth interviews covering personal history, mental health evaluation, stability assessment, and exploration of emotional readiness. Openness and honesty are crucial.

What emotional preparations should surrogates make?

Surrogates should understand their motivations, be emotionally prepared for the challenges, and have a strong support system.

What responsibilities do all parties have in surrogacy?

Both Intended Parents and surrogates should be well-informed about medical procedures, potential risks, and have a clear, legally binding agreement outlining rights and responsibilities. Open communication, empathy, and a supportive environment are essential for a positive surrogacy experience.

How can surrogates address potential emotional challenges during the journey?

Surrogates should be aware that support services, including counseling, may be offered throughout the surrogacy journey to address any emotional needs that may arise.


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Bridget Myers

Bridget Myers grew up in small town in Maryland. She started her career as a substitute teacher before meeting the love of her life and moving to the suburbs of Chicago. She has a passion for dogs and painting. Bridget got involved in Surrogacy Place after researching surrogacy for her best friend. Since joining the team at Surrogacy Place, she has developed a passion for advocating on behalf of Intended Parents and surrogates and doing her part for meaningful reform in the industry.