Considering Surrogacy? Here’s What You Need to Know About the Surrogacy Process
Surrogacy is an advanced assisted reproduction arrangement where a woman, known as the surrogate, surrogate mother, or gestational carrier, carries and gives birth to a baby on behalf of another individual or couple, referred to as the Intended Parents. The Intended Parents may be unable to conceive or carry a pregnancy due to biological limitations, or medical reasons. In gestational surrogacy, the surrogate is not genetically related to the child she carries as the embryo is created through In Vitro Fertilization (IVF) using the Intended Parents’ or donor’s gametes. Throughout the process, all parties involved work together, generally with legal agreements, and undergo comprehensive medical and psychological screenings to ensure a positive and fulfilling surrogacy journey for everyone.
There are two main types of surrogacy: traditional surrogacy and gestational surrogacy. We’ll focus on gestational surrogacy as it is the most common form and doesn’t involve the surrogate’s genetic contribution.
Step 1: Initial Consultation and Decision Making
The Intended Parents, who wish to have a child, discuss their options with a Reproductive Endocrinologist or fertility specialist. Through a careful analysis of each person’s unique and very specific situation, surrogacy may be advised.
A fertility specialist might recommend a gestational surrogate for several reasons, especially when the Intended Parents face specific medical challenges that prevent them from carrying a pregnancy to term. An Intended Mother may have certain medical conditions that make pregnancy risky or impossible, such as a malformed uterus, repeated pregnancy loss, or severe heart or kidney problems. In such cases, carrying a pregnancy could jeopardize her health and the well-being of the baby. If an Intended Mother has undergone multiple unsuccessful IVF (In Vitro Fertilization) cycles or implantation failures, the fertility specialist may recommend using a gestational surrogate as an alternative to increase the chances of a successful pregnancy. Women who were born without a uterus or have had a hysterectomy may not have the physical capability to carry a pregnancy. In these cases, a gestational surrogate becomes the best option for Intended Parents to have a biological child. If an Intended Mother has a medical history of cancer, autoimmune disorders, or other serious health conditions that require ongoing treatments or medications incompatible with pregnancy, a gestational surrogate may be recommended.
In cases where same-sex male couples desire to have a biological child, a gestational surrogate is needed to carry an embryo, using one’s own or partner’s sperm along with a donor egg.
Sometimes, fertility issues remain unexplained despite thorough testing and evaluation. In these cases, a gestational surrogate might be recommended if other fertility treatments have been unsuccessful. Additionally, if an Intended Mother experiences recurrent pregnancy loss due to underlying medical factors that cannot be resolved, using a gestational surrogate may be considered to minimize the risk of further losses.
When deciding to pursue surrogacy, Intended Parents need to decide whether to use their own gametes (eggs and sperm) or whether they will need an egg, sperm, or embryo donor.
Step 2: Selecting a Surrogate
The Intended Parents look for a suitable surrogate who meets a wide variety of important criteria. The surrogate will undergo extensive medical and psychological screenings to ensure she is physically and emotionally prepared for the surrogacy journey. Some of the requirements include excellent physical and mental health, a history of uncomplicated pregnancies, and a willingness to commit to the process. Additionally, a qualified assisted-reproduction attorney will be needed to sure a surrogate meets the legal and ethical guidelines for surrogacy.
After a match is completed and a surrogate is cleared by the Intended Parent(s)’ fertility clinic, they proceed to the legal phase where agreements are drafted and finalized.
Step 3: Legal Agreements
The Intended Parents and the surrogate, along with their respective legal representatives, create a legal agreement detailing the rights, responsibilities, and expectations of all parties involved.
The agreement covers sensitive issues such as parental rights, financial compensation, medical decisions, and the responsibilities of both parties throughout the process and after birth. The agreements must be finalized and fully executed before embryo transfer.
The Intended Mother or egg donor (if not using the Intended Mother’s eggs) undergoes ovarian stimulation to produce multiple eggs for fertilization. The eggs retrieved from the Intended Mother or egg donor are fertilized in the laboratory with the Intended Father’s sperm or donor sperm. The resulting embryos are then cultured and monitored for a few days to select the healthiest ones for transfer.
One or more selected embryos are then transferred into the uterus of the surrogate. In nearly all cases, a single embryo transfer is done to avoid the risks of multiples which can significantly increase the risk of pregnancy complications.
Step 5: Pregnancy and Monitoring
If the embryo transfer is successful and an embryo implants in the surrogate’s uterus, she becomes pregnant with the Intended Parents’ child. Throughout the pregnancy, the surrogate receives regular prenatal check-ups and necessary medical care to ensure the health of the baby and herself.
The Intended Parents may also participate in the pregnancy journey and attend medical appointments if possible and agreed upon.
Step 6: Birth and Post-Birth Process
When the baby is born, the Intended Parents are usually present for the delivery and immediately assume legal and financial responsibility for the child(ren) upon birth. The birth certificate can be issued in the Intended Parents’ names depending on state surrogacy laws. After the birth, the surrogate may have a post-birth relationship with the child, depending on what was agreed upon by all parties.
Step 7: Post-Birth Legal Process
Where Pre-Birth Orders are unavailable, following the birth, Intended Parents will need to complete legal procedures to secure their parental rights fully. This process may involve obtaining court orders or parentage orders, depending on the laws of the state where the surrogacy took place.
How Much does Surrogacy Cost?
The location where the surrogacy takes place plays a significant role in determining the overall cost. Surrogacy laws and regulations differ between states. Some regions have more favorable legal environments for surrogacy, which can affect the ease of the process and the associated costs. Additionally, legal expenses, such as drafting and reviewing contracts, court fees, and obtaining parental rights, can add to the overall cost. Intended parents should also consider the potential expenses related to travel, accommodations, and other logistical aspects when choosing a surrogacy location.
Agency vs Independent Surrogacy:
Intended parents can pursue surrogacy through an agency or choose to match independently and save large sums of money while potentially finding their surrogate more quickly. Many surrogates prefer not to use agencies, so there are a large number of surrogates available that aren’t signed to any agency. The convenience of using an agency to find a surrogate often comes with significantly higher costs and, quite often, a more limited pool of surrogates to choose from. Surrogacy agencies do not disclose how many surrogates they work with and waitlists can be very long for Intended Parents. In independent surrogacy, where the Intended Parents find a surrogate on their own using a site like SurrogacyPlace.com, Intended Parents can save a lot of money (in the tens of thousands of dollars or more!), but they also need to take responsibility for self-matching. If going without an agency, your assisted reproduction attorney can provide you with a list of things you’ll need to do to complete your responsibilities legally and ethically. Whether you go independent or use an agency, you will need to pay for an assisted reproduction specializing attorney and his/her guidance is an imperative part of the process. Read this post about important things to consider when looking for a qualified surrogate.
Medical expenses constitute a significant portion of the costs of surrogacy. These expenses include the costs associated with IVF (In Vitro Fertilization), fertility medications, embryo transfer procedures, prenatal care for the surrogate, and delivery. Additionally, Intended Parents are responsible for covering the surrogate’s health insurance plan unless her existing plan covers surrogacy already. Intended Parents must cover any additional policies required to ensure comprehensive medical care throughout the pregnancy. The cost may also increase if multiple IVF attempts are necessary or if unforeseen medical complications arise during the surrogacy journey.
The total cost of surrogacy is influenced by factors such as the surrogacy location and its legal implications, the choice between agency and independent surrogacy, and the medical expenses and insurance coverage involved. It’s crucial for Intended Parents to thoroughly research and consider these factors, as well as any other related expenses, to plan and budget effectively for their surrogacy journey.
FAQ: The Surrogacy Process Explained
What is surrogacy and how does it work?
Surrogacy is an advanced assisted reproduction arrangement where a woman, known as the surrogate or gestational carrier, carries and gives birth to a baby on behalf of another individual or couple, referred to as the Intended Parents. This process is typically recommended when the Intended Parents face specific medical challenges that prevent them from carrying a pregnancy themselves. In gestational surrogacy, the surrogate is not genetically related to the child she carries, as the embryo is created through In Vitro Fertilization (IVF) using the Intended Parents’ or donor’s gametes.
What are the two types of surrogacy and which one is more common?
There are two types of surrogacy: traditional surrogacy and gestational surrogacy. In gestational surrogacy, which is the most common form, the surrogate is not genetically related to the child she carries. The embryo is created through IVF, using the Intended Parents’ or donor’s gametes, and then transferred into the surrogate’s uterus. This method avoids the complexities associated with traditional surrogacy, where the surrogate contributes her own egg and is genetically related to the child she carries.
What are the key steps involved in the surrogacy process?
The surrogacy process involves several essential steps:
Step 1: Initial Consultation and Decision Making: The Intended Parents consult with a Reproductive Endocrinologist or fertility specialist to discuss surrogacy.
Step 2: Selection of Surrogate: The Intended Parents look for a suitable surrogate who meets specific criteria, including good physical and mental health and a history of uncomplicated pregnancies.
Step 3: Legal Agreements: Both parties, along with their respective legal representatives, create a detailed legal agreement outlining rights, responsibilities, and expectations during and after the surrogacy journey.
Step 4: In Vitro Fertilization (IVF) Process: The Intended Mother or egg donor undergoes ovarian stimulation to produce eggs for fertilization, which are then combined with the Intended Father’s sperm or donor sperm in the laboratory. The resulting embryos are transferred into the surrogate’s uterus.
Step 5: Pregnancy and Monitoring: If the embryo transfer is successful, the surrogate becomes pregnant with the Intended Parents’ child, and regular prenatal care is provided to ensure a healthy pregnancy.
Step 6: Birth and Post-Birth Process: The baby is born, and the Intended Parents assume legal parenthood.
How much does surrogacy typically cost?
The cost of surrogacy can vary depending on several factors. Key cost determinants include the surrogacy location, legal expenses, agency or independent surrogacy, medical expenses (IVF, medications, prenatal care, etc.), and insurance coverage for the surrogate. Surrogacy laws and regulations vary by country and region, impacting overall expenses. Using a surrogacy agency generally entails higher costs due to their fees for matching, while independent surrogacy can be a great more cost-effective option for Intended Parents (with a potentially wider pool of surrogates to choose from!). It’s essential for Intended Parents to thoroughly research and budget for all associated expenses when considering surrogacy. Working with a qualified assisted reproduction attorney is necessary, regardless of the surrogacy method chosen, to ensure the process adheres to legal and ethical guidelines.